MEDICARE: WINDY DIPIETRO M.A. LMFT

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	106H00000X	Marriage & Family Therapist	34473	CA

General Provider Information

NPI Number	:	1679099733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WINDY DIPIETRO M.A. LMFT

Provider Business Mailing Address
First Line	:	11753 HIDDEN VALLEY RD
Second Line	:
City	:	GRASS VALLEY
State	:	CA
Zip	:	95949-8706
Country	:	US
Telephone Number	:	530-273-5355
Fax Number	:

Provider Business Practice Location Address
First Line	:	11753 HIDDEN VALLEY RD
Second Line	:
City	:	GRASS VALLEY
State	:	CA
Zip	:	95949-8706
Country	:	US
Telephone Number	:	530-273-5355
Fax Number	:

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

Provider Enumeration Date	:	08/20/2017
Last Update Date	:	07/21/2022

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