Provider Demographics
NPI:1508988809
Name:FIORI, TODD MICHAEL (MFT, PPS)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:MICHAEL
Last Name:FIORI
Suffix:
Gender:M
Credentials:MFT, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 UNION SQUARE RD
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-5178
Mailing Address - Country:US
Mailing Address - Phone:916-752-0309
Mailing Address - Fax:
Practice Address - Street 1:1020 SUNDOWN WAY, SUITE 100
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4473
Practice Address - Country:US
Practice Address - Phone:916-784-6102
Practice Address - Fax:916-784-6170
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 39013106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist