Provider Demographics
NPI:1881991693
Name:VRABLIK, MATTHEW DAVID (MA, MFT)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:DAVID
Last Name:VRABLIK
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 W OLIVE AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-7660
Mailing Address - Country:US
Mailing Address - Phone:408-412-9442
Mailing Address - Fax:408-940-0122
Practice Address - Street 1:355 W OLIVE AVE STE 214
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-7660
Practice Address - Country:US
Practice Address - Phone:408-412-9442
Practice Address - Fax:408-940-0122
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53882106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist