Provider Demographics
NPI:1154355394
Name:GHILARDI, LOUIS JAMES (MFT 16302)
Entity type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:JAMES
Last Name:GHILARDI
Suffix:
Gender:M
Credentials:MFT 16302
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4713 1ST ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7361
Mailing Address - Country:US
Mailing Address - Phone:925-462-0220
Mailing Address - Fax:925-484-2449
Practice Address - Street 1:4713 1ST ST
Practice Address - Street 2:SUITE 250
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7361
Practice Address - Country:US
Practice Address - Phone:925-462-0220
Practice Address - Fax:925-484-2449
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 16302106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist