Provider Demographics
NPI:1396883013
Name:VERMILION, ADRIANNA MARIE (MFT)
Entity type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:MARIE
Last Name:VERMILION
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:ADRIANNA
Other - Middle Name:MARIE
Other - Last Name:STEFANKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:PO BOX 1295
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-0044
Mailing Address - Country:US
Mailing Address - Phone:626-695-5495
Mailing Address - Fax:
Practice Address - Street 1:2900 ADAMS ST STE A350
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-8303
Practice Address - Country:US
Practice Address - Phone:626-695-5495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40200106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist