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NPI 1689736068

NPI 1689736068 : MAREN MARTIN LCSW : PACIFIC GROVE, CA

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General NPI Number Information
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    NPI Number           |    1689736068
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    Entity Type          |    Individual 
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    Provider Name        |    MAREN MARTIN LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/14/2006
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    Last Update Date     |    06/21/2021
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Provider Practice Location Address
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    Address Line         |    207 16TH ST # 305 
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    City                 |    PACIFIC GROVE
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    State                |    CA
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    Zip                  |    93950-3355
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    Country              |    US
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    Telephone            |    831-375-1134
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    Fax                  |    831-375-1134
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Provider Business Mailing Address
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    Address Line         |    207 16TH ST # 305 
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    City                 |    PACIFIC GROVE
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    State                |    CA
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    Zip                  |    93950-3355
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    Country              |    US
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    Telephone            |    831-375-1134
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    Fax                  |    831-375-1134
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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       |    LCS19351
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    License Number State |    CA
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