Provider Demographics
NPI:1831600246
Name:SETTLE, MATTHEW T
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:T
Last Name:SETTLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 DRAKE CIR
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-4908
Mailing Address - Country:US
Mailing Address - Phone:805-459-5429
Mailing Address - Fax:
Practice Address - Street 1:555 S 13TH ST STE L
Practice Address - Street 2:
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-2866
Practice Address - Country:US
Practice Address - Phone:805-459-5429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102334106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist