Provider Demographics
NPI:1790856979
Name:PIAZZA, MARIE FRANCES (MFT)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:FRANCES
Last Name:PIAZZA
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 1:858 4TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4597
Mailing Address - Country:US
Mailing Address - Phone:707-570-3940
Mailing Address - Fax:707-570-3941
Practice Address - Street 1:858 4TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4597
Practice Address - Country:US
Practice Address - Phone:707-570-3940
Practice Address - Fax:707-570-3941
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28026106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist