MEDICARE: TERESE GHILARDUCCI MFT36326

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YS0200X	School Counselor		CA
2	106H00000X	Marriage & Family Therapist	36326	CA

General Provider Information

NPI Number	:	1396341632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESE GHILARDUCCI MFT36326

Provider Business Mailing Address
First Line	:	632 SHERI LN
Second Line	:
City	:	DANVILLE
State	:	CA
Zip	:	94526-3934
Country	:	US
Telephone Number	:	925-872-5858
Fax Number	:

Provider Business Practice Location Address
First Line	:	632 SHERI LN
Second Line	:
City	:	DANVILLE
State	:	CA
Zip	:	94526-3934
Country	:	US
Telephone Number	:	925-872-5858
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2020
Last Update Date	:	12/09/2025

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