Michele Diana Corgiat, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT40776 Issued in CA

Practice address

2125 Wylie Dr
Suite 9
Modesto, CA 95355-3800

Phone

(209) 402-2717

Fax

(209) 529-0404

NPI assigned

Jul 4, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Michele Diana Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275563124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579743",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953579743",
            "telephone_number": "209-402-2717",
            "fax_number": "209-529-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 WYLIE DR",
            "address_2": "SUITE 9",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553800",
            "telephone_number": "209-402-2717",
            "fax_number": "209-529-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORGIAT",
        "first_name": "MICHELE",
        "middle_name": "DIANA",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT40776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "JOHNSON",
            "middle_name": "DIANA",
            "prefix": "MISS",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leah Rae Cordova
• Patricia Cordova
• Core Therapy, Inc.
• Corey R. Acree DDS, Inc.
• Cyndel Corgiat, CMT
• Jorge Coria Pena
• Eduardo Corjasso Jr.
• Alyson Cornelius, PHARMD
• Cornerstone Caregiving West LLC
• Cornerstone Family Medical Group, a Professional Corporation

• Marriage & Family Therapist in Modesto, CA
• Providers in Modesto, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.