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General NPI Number Information
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NPI Number | 1700748308
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Entity Type | Organization
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Legal Business Name | NICHOLAS GIARDINO PHD PSYCHOLOGY PC
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 130 PETALUMA AVE STE 2B
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City | SEBASTOPOL
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State | CA
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Zip | 95472-4234
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Country | US
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Telephone | 707-360-2090
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Fax |
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Provider Business Mailing Address
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Address Line | 625 DUFRANC AVE
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City | SEBASTOPOL
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State | CA
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Zip | 95472-3342
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | NICHOLAS GIARDINO
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Credential | PHD
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Telephone | 734-330-1069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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