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General NPI Number Information
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NPI Number | 1548692023
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Entity Type | Individual
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Provider Name | LYNDA MARTIN
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Gender | Female
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 254 W 54TH ST
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City | NEW YORK
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State | NY
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Zip | 10019-5516
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Country | US
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Telephone | 973-475-5131
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Fax |
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Provider Business Mailing Address
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Address Line | 450 STANYAN ST.
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-1019
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Country | US
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Telephone | 650-867-0954
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 83400
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 001387
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License Number State | NY
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