Basic Information
| Provider Information | |||||||||
| NPI: | 1851518948 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIERPAOLI | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | RAYMOND | ||||||||
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| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PIERPAOLI | ||||||||
| OtherFirstName: | LONESOME SPARROW | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 592 JEAN ST | ||||||||
| Address2: | APARTMENT 203. | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946101955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103855978 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 205 PACIFICA AVE | ||||||||
| Address2: | |||||||||
| City: | BAY POINT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945652904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9254583216 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.