Provider Demographics
NPI:1548396740
Name:PASTOR, MARTINE NA (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:MARTINE
Middle Name:NA
Last Name:PASTOR
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:DR
Other - First Name:MARTINE
Other - Middle Name:NA
Other - Last Name:ANIEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYCHOLOGIST
Mailing Address - Street 1:2540 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2616
Mailing Address - Country:US
Mailing Address - Phone:415-441-8970
Mailing Address - Fax:415-584-8174
Practice Address - Street 1:2540 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2616
Practice Address - Country:US
Practice Address - Phone:415-441-8970
Practice Address - Fax:415-584-8174
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY9685103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical