Provider Demographics
NPI:1326061573
Name:MARTINSON, LANCE (LCSW)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:
Last Name:MARTINSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:LANCE
Other - Middle Name:
Other - Last Name:MARTINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:4150 CLEMENT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1545
Mailing Address - Country:US
Mailing Address - Phone:415-551-7336
Mailing Address - Fax:415-861-2008
Practice Address - Street 1:4150 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1545
Practice Address - Country:US
Practice Address - Phone:415-551-7336
Practice Address - Fax:415-861-2008
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS58471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical