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General NPI Number Information
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NPI Number | 1518626266
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Entity Type | Individual
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Provider Name | CIBELLE AZADUI
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Gender | Female
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Dates
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Enumeration Date | 12/09/2021
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 1423 BROADWAY
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City | OAKLAND
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State | CA
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Zip | 94612-2054
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Country | US
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Telephone | 510-838-1206
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Fax |
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Provider Business Mailing Address
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Address Line | 14205 N MO PAC EXPY STE 570 PMB 113548
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City | AUSTIN
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State | TX
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Zip | 78728
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Country | US
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Telephone | 512-270-0711
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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 | 205130
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License Number State | TX
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