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General NPI Number Information
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NPI Number | 1154521433
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Entity Type | Individual
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Provider Name | MARTIN B LAPLACA LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 286 EUCLID AVE
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City | SAN DIEGO
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State | CA
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Zip | 92114-3610
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Country | US
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Telephone | 619-859-6270
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Fax | 619-527-8536
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Provider Business Mailing Address
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Address Line | 46 WINDSOR AVE
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City | KENSINGTON
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State | CA
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Zip | 94708-1041
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Country | US
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Telephone | 510-644-0666
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCSW26211
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 26211
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License Number State | CA
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