Provider Demographics
NPI:1629700786
Name:PIANE, GINA MARIE (MPH, DRPH, MA)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:PIANE
Suffix:
Gender:F
Credentials:MPH, DRPH, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 JAMBOREE RD STE 263
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3002
Mailing Address - Country:US
Mailing Address - Phone:562-477-0057
Mailing Address - Fax:
Practice Address - Street 1:4425 JAMBOREE RD STE 263
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-3002
Practice Address - Country:US
Practice Address - Phone:562-477-0057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA125091106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist