Provider Demographics
NPI:1811775190
Name:MARTINEAU, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MARTINEAU
Suffix:
Gender:F
Credentials:
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 3712
Mailing Address - Street 2:
Mailing Address - City:OLYMPIC VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:96146-3712
Mailing Address - Country:US
Mailing Address - Phone:650-575-5309
Mailing Address - Fax:
Practice Address - Street 1:2361 JOHN SCOTT TRL
Practice Address - Street 2:
Practice Address - City:ALPINE MEADOWS
Practice Address - State:CA
Practice Address - Zip Code:96146-9818
Practice Address - Country:US
Practice Address - Phone:650-575-5309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist