Provider Demographics
NPI:1598948523
Name:MARUM, DOUGLASS LYNN (PHD MARRIAGE AND FAM)
Entity Type:Individual
Prefix:DR
First Name:DOUGLASS
Middle Name:LYNN
Last Name:MARUM
Suffix:
Gender:M
Credentials:PHD MARRIAGE AND FAM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 LINCOLN AVE
Mailing Address - Street 2:STE 305B
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558
Mailing Address - Country:US
Mailing Address - Phone:707-257-3500
Mailing Address - Fax:707-257-3533
Practice Address - Street 1:575 LINCOLN AVE
Practice Address - Street 2:STE 305B
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558
Practice Address - Country:US
Practice Address - Phone:707-257-3500
Practice Address - Fax:707-257-3533
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT7799106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist