Provider Demographics
NPI:1518273309
Name:LANDAU-NORTH, MARTIN (MFT)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:LANDAU-NORTH
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 1:665 SAN RODOLFO DRIVE
Mailing Address - Street 2:SUITE 124-114
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075
Mailing Address - Country:US
Mailing Address - Phone:858-345-1505
Mailing Address - Fax:858-815-7939
Practice Address - Street 1:731 SOUTH HIGHWAY 101
Practice Address - Street 2:SUITE 2J
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075
Practice Address - Country:US
Practice Address - Phone:858-345-1505
Practice Address - Fax:858-815-7939
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43091106H00000X
CALMFT43091106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist