Provider Demographics
NPI:1104062660
Name:ADRIANCE, WAYNE DOUGLAS (MFTI)
Entity type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:DOUGLAS
Last Name:ADRIANCE
Suffix:
Gender:M
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 FAIRBANKS AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-1510
Mailing Address - Country:US
Mailing Address - Phone:831-239-4606
Mailing Address - Fax:
Practice Address - Street 1:3184 OLD TUNNEL ROAD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549
Practice Address - Country:US
Practice Address - Phone:831-239-4606
Practice Address - Fax:831-239-4606
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health