Provider Demographics
NPI:1760509640
Name:MARRINER, CAULETTA S (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CAULETTA
Middle Name:S
Last Name:MARRINER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6605 BRET HARTE DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-2011
Mailing Address - Country:US
Mailing Address - Phone:408-927-9247
Mailing Address - Fax:
Practice Address - Street 1:6605 BRET HARTE DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-2011
Practice Address - Country:US
Practice Address - Phone:408-927-9247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
CAMFC14112101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional