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General NPI Number Information
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NPI Number | 1851709687
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Entity Type | Organization
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Legal Business Name | LYNDA KATE MARTIN
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Dates
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Enumeration Date | 07/24/2014
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Last Update Date | 07/24/2014
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Provider Practice Location Address
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Address Line | 10535 FOOTHILL BLVD SUITE 360
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3843
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Country | US
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Telephone | 909-499-2047
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Fax |
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Provider Business Mailing Address
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Address Line | 10535 FOOTHILL BLVD SUITE 360
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3843
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Country | US
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Telephone | 909-499-2047
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Fax |
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Authorized Official
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Title or Position | LICENSED MARRIAGE AND FAMILY THERAP
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Name | MRS. LYNDA KATE MARTIN
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Credential | LMFT
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Telephone | 909-499-2047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | LMFT81068
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License Number State | CA
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