Provider Demographics
NPI:1871391920
Name:MERLI, ILONA (AMFT)
Entity type:Individual
Prefix:
First Name:ILONA
Middle Name:
Last Name:MERLI
Suffix:
Gender:
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-6826
Mailing Address - Country:US
Mailing Address - Phone:408-839-6965
Mailing Address - Fax:
Practice Address - Street 1:16400 BLOSSOM HILL RD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-3553
Practice Address - Country:US
Practice Address - Phone:408-839-6965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA153388106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist