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General NPI Number Information
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NPI Number | 1992929392
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Entity Type | Individual
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Provider Name | MAIA CLARISE GIOVANNOLI B.S.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 06/15/2009
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Provider Practice Location Address
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Address Line | 668 QUINAN ST SUITE #100
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City | PINOLE
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State | CA
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Zip | 94564-1621
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Country | US
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Telephone | 510-741-7286
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Fax |
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Provider Business Mailing Address
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Address Line | 3349 BRENTWOOD AVE
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City | EL SOBRANTE
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State | CA
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Zip | 94803-2512
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Country | US
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Telephone | 707-696-0038
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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