Provider Demographics
NPI:1376701557
Name:MORIN, THOMAS A (MFT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:MORIN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 VIA CASITAS
Mailing Address - Street 2:
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-1839
Mailing Address - Country:US
Mailing Address - Phone:415-464-0234
Mailing Address - Fax:415-461-3054
Practice Address - Street 1:4283 PIEDMONT AVE
Practice Address - Street 2:SUITE E 3
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-4713
Practice Address - Country:US
Practice Address - Phone:415-464-0234
Practice Address - Fax:415-461-3054
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-25
Last Update Date:2008-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 30190106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist