MEDICARE: TONALLI COUNSELING AND WELLNESS A LICENSED CLINICAL SOCIAL WORKER CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1568179786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TONALLI COUNSELING AND WELLNESS A LICENSED CLINICAL SOCIAL WORKER CORP

Provider Business Mailing Address
First Line	:	23 AVENIDA DE ORINDA STE 61C
Second Line	:
City	:	ORINDA
State	:	CA
Zip	:	94563-2305
Country	:	US
Telephone Number	:	510-825-3344
Fax Number	:

Provider Business Practice Location Address
First Line	:	23 AVENIDA DE ORINDA STE 61C
Second Line	:
City	:	ORINDA
State	:	CA
Zip	:	94563-2305
Country	:	US
Telephone Number	:	510-825-3344
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	ADRIANA MARTINEZ
Credential	:
Telephone Number	:	510-825-3344

Provider Enumeration Date	:	10/28/2022
Last Update Date	:	03/12/2026

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