Healthcare Provider Details
I. General information
NPI: 1154247492
Provider Name (Legal Business Name): SOMATIC FAMILY THERAPY OF MARIN, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
385 SAN GERONIMO VALLEY DRIVE
SAN GERONIMO CA
94963
US
IV. Provider business mailing address
PO BOX 245
SAN GERONIMO CA
94963-0245
US
V. Phone/Fax
- Phone: 415-521-0799
- Fax:
- Phone: 415-521-0799
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CAROLYN
GEREAU
Title or Position: PRESIDENT
Credential: LMFT
Phone: 415-521-0799