| Doctor Name: | DR. RICHARD GIOVANNOLI |
| NPI Number: | 1013130806 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | PSY22314 |
| Business Practice Address: | 874 Gravenstein Highway South Suite 12 Sebastopol, CA - 954725603 |
| Business Phone Number: | 7078248834 |
| Business Fax Number: | 7079220294 |
| Mailing Address: | 874 Gravenstein Highway South, Suite 12 SEBASTOPOL |
| State: | CA |
| Postal Code: | 954725603 |
| Phone Number: | 7078248834 |
| Fax Number: | 7079220294 |
| NPI Enumeration Date: | 04/10/2007 |
| NPI Last Update Date: | 10/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | PSY22314 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |