Healthcare Provider Details

I. General information

NPI: 1932032208
Provider Name (Legal Business Name): MARTINA ANNA DE SANTIS AMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3368 SACRAMENTO ST
SAN FRANCISCO CA
94118-1912
US

IV. Provider business mailing address

1001 BRIDGEWAY STE A
SAUSALITO CA
94965-2104
US

V. Phone/Fax

Practice location:
  • Phone: 415-484-1050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberAPCC22738
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT162734
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: