Provider Demographics
NPI:1932326006
Name:SINCLAIR, MARILYN JOAN (MFT)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:JOAN
Last Name:SINCLAIR
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 1:490 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-2943
Mailing Address - Country:US
Mailing Address - Phone:562-591-8701
Mailing Address - Fax:562-599-3715
Practice Address - Street 1:490 W 14TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-2943
Practice Address - Country:US
Practice Address - Phone:562-591-8701
Practice Address - Fax:562-599-3715
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 18603106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist