Provider Demographics
NPI:1881069565
Name:NARAYAN, MARIA GRAZIA (JD, MA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:GRAZIA
Last Name:NARAYAN
Suffix:
Gender:F
Credentials:JD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3348
Mailing Address - Country:US
Mailing Address - Phone:415-419-3600
Mailing Address - Fax:
Practice Address - Street 1:600 5TH AVE
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3348
Practice Address - Country:US
Practice Address - Phone:415-419-3656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119648106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist