MEDICARE: CLINTON CRETCHER

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	153972	CA

General Provider Information

NPI Number	:	1295339646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLINTON CRETCHER

Provider Business Mailing Address
First Line	:	343 DOLPHIN ISLE
Second Line	:
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-1452
Country	:	US
Telephone Number	:	650-274-5466
Fax Number	:

Provider Business Practice Location Address
First Line	:	343 DOLPHIN ISLE
Second Line	:
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-1452
Country	:	US
Telephone Number	:	650-274-5466
Fax Number	:

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

Provider Enumeration Date	:	11/25/2020
Last Update Date	:	01/19/2026

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Directions to “ CLINTON CRETCHER ” Practice Location

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