Provider Demographics
NPI:1629689054
Name:GIANOLA, KRISTINA NICOLE
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:NICOLE
Last Name:GIANOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRIS
Other - Middle Name:
Other - Last Name:CHAPPLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5800 STANFORD RANCH RD STE 420
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-4386
Mailing Address - Country:US
Mailing Address - Phone:916-953-4172
Mailing Address - Fax:
Practice Address - Street 1:5800 STANFORD RANCH RD STE 420
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-4386
Practice Address - Country:US
Practice Address - Phone:916-953-4172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA151646106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist