Healthcare Provider Details

I. General information

NPI: 1194448274
Provider Name (Legal Business Name): MARISA SOMMERHALDER AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 QUAIL CT STE 102
WALNUT CREEK CA
94596-5590
US

IV. Provider business mailing address

783 DIABLO RD
DANVILLE CA
94526-2731
US

V. Phone/Fax

Practice location:
  • Phone: 925-899-8857
  • Fax:
Mailing address:
  • Phone: 925-899-8857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: