Provider Demographics
NPI:1861547887
Name:GIARRITTA, MICHAEL ALFONCE (MFT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALFONCE
Last Name:GIARRITTA
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 W D ST N
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:CA
Mailing Address - Zip Code:95620-2742
Mailing Address - Country:US
Mailing Address - Phone:707-678-9640
Mailing Address - Fax:
Practice Address - Street 1:3700 VACA VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-9430
Practice Address - Country:US
Practice Address - Phone:707-453-5356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 33126106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist