Provider Demographics
NPI:1629081252
Name:GIARDINI, ALYSON M (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ALYSON
Middle Name:M
Last Name:GIARDINI
Suffix:
Gender:F
Credentials:LMFT
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 472
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:CA
Mailing Address - Zip Code:95914-0472
Mailing Address - Country:US
Mailing Address - Phone:510-594-4066
Mailing Address - Fax:510-594-4066
Practice Address - Street 1:9214 MARYSVILLE RD
Practice Address - Street 2:
Practice Address - City:OREGON HOUSE
Practice Address - State:CA
Practice Address - Zip Code:95962-9705
Practice Address - Country:US
Practice Address - Phone:510-594-4066
Practice Address - Fax:510-594-4066
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39327106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist