Provider Demographics
NPI:1831911924
Name:PIAZZA, JANA (MA, AMFT, LPCC)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:PIAZZA
Suffix:
Gender:F
Credentials:MA, AMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 210022
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-0022
Mailing Address - Country:US
Mailing Address - Phone:207-266-0982
Mailing Address - Fax:
Practice Address - Street 1:182 SAN GERONIMO VALLEY DRIVE
Practice Address - Street 2:
Practice Address - City:WOODACRE
Practice Address - State:CA
Practice Address - Zip Code:94973
Practice Address - Country:US
Practice Address - Phone:207-266-0982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
17424101YM0800X
CA148850106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health