Provider Demographics
NPI:1255578852
Name:SCORNAIENCHI, ANGELA (MFT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:SCORNAIENCHI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 SAN BENITO ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-4874
Mailing Address - Country:US
Mailing Address - Phone:831-524-3634
Mailing Address - Fax:831-638-9573
Practice Address - Street 1:930 SAN BENITO ST
Practice Address - Street 2:SUITE 10
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-4874
Practice Address - Country:US
Practice Address - Phone:831-524-3634
Practice Address - Fax:831-638-9573
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-19
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32404106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist