Provider Demographics
NPI:1851709687
Name:LYNDA KATE MARTIN
Entity Type:Organization
Organization Name:LYNDA KATE MARTIN
Other - Org Name:PLAN B... THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED MARRIAGE AND FAMILY THERAP
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:KATE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-499-2047
Mailing Address - Street 1:10535 FOOTHILL BLVD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3843
Mailing Address - Country:US
Mailing Address - Phone:909-499-2047
Mailing Address - Fax:
Practice Address - Street 1:10535 FOOTHILL BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3843
Practice Address - Country:US
Practice Address - Phone:909-499-2047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT81068261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health