Provider Demographics
NPI:1740607266
Name:PIAZZA, MICHELLE (CADCII)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:PIAZZA
Suffix:
Gender:F
Credentials:CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 E COOLEY DR # B8
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-6324
Mailing Address - Country:US
Mailing Address - Phone:909-370-1777
Mailing Address - Fax:909-370-1776
Practice Address - Street 1:2275 E COOLEY DR # B8
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-6324
Practice Address - Country:US
Practice Address - Phone:909-370-1777
Practice Address - Fax:909-370-1776
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)