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General NPI Number Information
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NPI Number | 1487706131
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Entity Type | Individual
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Provider Name | CLAUDIA RENATE VIAZZOLI PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 311 MILLER AVE STE L
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City | MILL VALLEY
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State | CA
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Zip | 94941-2897
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Country | US
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Telephone | 415-755-8084
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Fax | 415-459-3715
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Provider Business Mailing Address
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Address Line | PO BOX 523
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City | SAN GERONIMO
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State | CA
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Zip | 94963-0523
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Country | US
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Telephone | 415-755-8084
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Fax | 415-459-3715
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSY19641
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 19641
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License Number State | CA
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