MEDICARE: MR. ANTHONY PAUL MARTELLO LMFT

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	159750	CA

General Provider Information

NPI Number	:	1255050894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANTHONY PAUL MARTELLO LMFT

Provider Business Mailing Address
First Line	:	747 BUCHON ST
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-4305
Country	:	US
Telephone Number	:	408-348-5358
Fax Number	:

Provider Business Practice Location Address
First Line	:	486 MARSH ST STE A
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93401-3894
Country	:	US
Telephone Number	:	805-305-4543
Fax Number	:

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

Provider Enumeration Date	:	08/25/2022
Last Update Date	:	02/16/2026

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