Provider Demographics
NPI:1740350065
Name:CAPITELLI, MARIA KRISTINA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:KRISTINA
Last Name:CAPITELLI
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 1:7158 SARONI DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-1421
Mailing Address - Country:US
Mailing Address - Phone:510-393-5866
Mailing Address - Fax:
Practice Address - Street 1:7158 SARONI DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-1421
Practice Address - Country:US
Practice Address - Phone:510-393-5866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46128106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7676OtherPROVIDER # FOR MEDI-CAL