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General NPI Number Information
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NPI Number | 1205219748
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Entity Type | Individual
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Provider Name | MARIANNE VON MICHALOFSKI
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Gender | Female
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Dates
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Enumeration Date | 07/01/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 4966 EL CAMINO REAL STE. 216
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City | LOS ALTOS
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State | CA
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Zip | 94022-1436
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Country | US
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Telephone | 650-336-0856
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 W EL CAMINO REAL #109-104
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City | SUNNYVALE
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State | CA
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Zip | 94087-1056
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Country | US
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Telephone | 650-305-9398
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 85856
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License Number State | CA
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