MEDICARE: REBECCA A MARTINEZ-THOMAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	114772	CA

General Provider Information

NPI Number	:	1184160061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA A MARTINEZ-THOMAS

Provider Business Mailing Address
First Line	:	1563 MISSION ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-2543
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1563 MISSION ST FL 3
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-2592
Country	:	US
Telephone Number	:	415-762-3700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2017
Last Update Date	:	10/17/2019

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