Healthcare Provider Details

I. General information

NPI: 1467778001
Provider Name (Legal Business Name): MARCY GALVEZ-STRINGHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 W HOSPITALITY LN SUITE 312
SAN BERNARDINO CA
92408-3243
US

IV. Provider business mailing address

325 W HOSPITALITY LN SUITE 312
SAN BERNARDINO CA
92408-3243
US

V. Phone/Fax

Practice location:
  • Phone: 909-386-5545
  • Fax:
Mailing address:
  • Phone: 909-386-5545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number67868
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF 67868
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number86779
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: