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General NPI Number Information
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NPI Number | 1295368843
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Entity Type | Individual
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Provider Name | MARTHA LUCIA MARIN-CUN LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/21/2020
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 1500 21ST ST
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City | SACRAMENTO
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State | CA
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Zip | 95811-5216
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Country | US
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Telephone | 916-914-6253
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2027
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-7027
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Country | US
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Telephone | 916-397-0881
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 94073
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License Number State | CA
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