Provider Demographics
NPI:1912426974
Name:TURNER, MARTIN (APPC 14727)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:TURNER
Suffix:
Gender:M
Credentials:APPC 14727
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3739 BALBOA ST. #1154
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-2605
Mailing Address - Country:US
Mailing Address - Phone:415-863-0487
Mailing Address - Fax:415-473-2718
Practice Address - Street 1:1263 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103
Practice Address - Country:US
Practice Address - Phone:415-502-3000
Practice Address - Fax:415-514-6466
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2024-01-05
Deactivation Date:2023-07-17
Deactivation Code:
Reactivation Date:2023-08-01
Provider Licenses
StateLicense IDTaxonomies
CAAPCC14727101YP2500X
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional