Provider Demographics
NPI:1255991873
Name:FOSTER, MADELINE MARI (LMFT)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:MARI
Last Name:FOSTER
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:PO BOX 4174
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-0174
Mailing Address - Country:US
Mailing Address - Phone:925-286-5228
Mailing Address - Fax:
Practice Address - Street 1:307 S B ST
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-4053
Practice Address - Country:US
Practice Address - Phone:650-200-0523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA136232106H00000X
CA149252106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist