Provider Demographics
NPI:1558645432
Name:PILECKI, MARIA MAGNOLIA (MS COUNSELING)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:MAGNOLIA
Last Name:PILECKI
Suffix:
Gender:F
Credentials:MS COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 SALAMANCA CT
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-2027
Mailing Address - Country:US
Mailing Address - Phone:925-866-0848
Mailing Address - Fax:
Practice Address - Street 1:3095 INDEPENDENCE DR
Practice Address - Street 2:BUILDING B SUITE A
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-7629
Practice Address - Country:US
Practice Address - Phone:925-443-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 51871101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor