Provider Demographics
NPI:1619688777
Name:VINCENTI, ADRIENNE ARRIGONI
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:ARRIGONI
Last Name:VINCENTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3506
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95402-3506
Mailing Address - Country:US
Mailing Address - Phone:707-303-8428
Mailing Address - Fax:
Practice Address - Street 1:1128 EDWARDS AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-8801
Practice Address - Country:US
Practice Address - Phone:650-576-1325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health