Doctor Name: | MS. EFSTATHIA PERIVOLIOTIS |
NPI Number: | 1003138660 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | |
Business Practice Address: | 2680 S White Rd San Jose, CA - 951482074 |
Business Phone Number: | 4087553905 |
Business Fax Number: | |
Mailing Address: | 3176 Napa Dr, SAN JOSE |
State: | CA |
Postal Code: | 951482026 |
Phone Number: | 4082099207 |
Fax Number: | |
NPI Enumeration Date: | 02/24/2010 |
NPI Last Update Date: | 10/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |