Healthcare Provider Details

I. General information

NPI: 1306858147
Provider Name (Legal Business Name): ARLENE S GIORDANO PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S FOREST RD
SONORA CA
95370-4895
US

IV. Provider business mailing address

P O BOX 154
SONORA CA
95370-0154
US

V. Phone/Fax

Practice location:
  • Phone: 209-533-2137
  • Fax: 209-532-3929
Mailing address:
  • Phone: 209-533-2137
  • Fax: 209-532-3929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY9078
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY9078
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: