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NPI Code Detail

MEDICARE: SHAON M. MARTINEAU LMFT

MEDICARE:   SHAON M. MARTINEAU  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
1106H00000XMarriage & Family Therapist
2390200000XStudent in an Organized Health Care Education/Training Program
3106H00000XMarriage & Family Therapist134279CA

General Provider Information

NPI Number : 1841730470
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAON M. MARTINEAU LMFT
Provider Business Mailing Address
First Line : 11428 KENYON WAY
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91701-9234
Country : US
Telephone Number : 909-948-1065
Fax Number :
Provider Business Practice Location Address
First Line : 11428 KENYON WAY
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91701-9234
Country : US
Telephone Number : 909-948-1065
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2017
Last Update Date : 10/18/2022

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Directions to “ SHAON M. MARTINEAU LMFT” Practice Location

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