Provider Demographics
NPI:1588040570
Name:MARIANNE C TROXELL LMFT & ASSOC. A MARRIAGE & FAMILY THERAPY CORP.
Entity Type:Organization
Organization Name:MARIANNE C TROXELL LMFT & ASSOC. A MARRIAGE & FAMILY THERAPY CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:TROXELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:650-997-0551
Mailing Address - Street 1:355 GELLERT BLVD STE 280
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2619
Mailing Address - Country:US
Mailing Address - Phone:650-997-0551
Mailing Address - Fax:650-564-9948
Practice Address - Street 1:355 GELLERT BLVD STE 280
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2619
Practice Address - Country:US
Practice Address - Phone:650-997-0551
Practice Address - Fax:650-564-9948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM19206302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization