Provider Demographics
NPI:1124814801
Name:BUNCE, MARINA
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:BUNCE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5280 IRENE WAY
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-3508
Mailing Address - Country:US
Mailing Address - Phone:925-606-4720
Mailing Address - Fax:
Practice Address - Street 1:5280 IRENE WAY
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-3508
Practice Address - Country:US
Practice Address - Phone:925-606-4720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool