Provider Demographics
NPI:1619932951
Name:PARKER, MARTHA (MFT,PHD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:MFT,PHD
Other - Prefix:DR
Other - First Name:MARTI
Other - Middle Name:
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT,PHD
Mailing Address - Street 1:10720 PARAMOUNT BLVD
Mailing Address - Street 2:SUITE 55
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3346
Mailing Address - Country:US
Mailing Address - Phone:562-861-1184
Mailing Address - Fax:562-861-1184
Practice Address - Street 1:10720 PARAMOUNT BLVD
Practice Address - Street 2:SUITE 55
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3346
Practice Address - Country:US
Practice Address - Phone:562-861-1184
Practice Address - Fax:562-861-1184
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT23335106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist