Provider Demographics
NPI:1689745630
Name:HINTZ, ROSEMARY MAYER (MFT)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:MAYER
Last Name:HINTZ
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 LA CUESTA DR
Mailing Address - Street 2:
Mailing Address - City:PORTOLA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94028-7534
Mailing Address - Country:US
Mailing Address - Phone:650-270-1606
Mailing Address - Fax:
Practice Address - Street 1:363 LA CUESTA DR
Practice Address - Street 2:
Practice Address - City:PORTOLA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94028-7534
Practice Address - Country:US
Practice Address - Phone:650-270-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48332106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist