Provider Demographics
NPI:1285762146
Name:SIRABELLA, MARIABRUNA (MS)
Entity type:Individual
Prefix:
First Name:MARIABRUNA
Middle Name:
Last Name:SIRABELLA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 WESTGATE DR
Mailing Address - Street 2:SUITE # 125
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-2461
Mailing Address - Country:US
Mailing Address - Phone:831-768-1442
Mailing Address - Fax:
Practice Address - Street 1:240 WESTGATE DR
Practice Address - Street 2:SUITE # 125
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2461
Practice Address - Country:US
Practice Address - Phone:831-768-1442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 36481106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist