Provider Demographics
NPI:1225240211
Name:DR. JUNE MARTIN, MARRIAGE AND FAMILY THERAPIST, INC.
Entity Type:Organization
Organization Name:DR. JUNE MARTIN, MARRIAGE AND FAMILY THERAPIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:650-348-4835
Mailing Address - Street 1:906 PACIFIC AVENUE
Mailing Address - Street 2:
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019
Mailing Address - Country:US
Mailing Address - Phone:650-703-9986
Mailing Address - Fax:650-712-8883
Practice Address - Street 1:215 NORTH SAN MATEO DRIVE
Practice Address - Street 2:SUITE #2
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401
Practice Address - Country:US
Practice Address - Phone:650-348-4835
Practice Address - Fax:650-712-8883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT30679251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health