1215143896 NPI number — MS. CHERYL ANN MARTIN-DEOCAMPO MA, LMFT

Table of content: MS. CHERYL ANN MARTIN-DEOCAMPO MA, LMFT (NPI 1215143896)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215143896 NPI number — MS. CHERYL ANN MARTIN-DEOCAMPO MA, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARTIN-DEOCAMPO
Provider First Name:
CHERYL
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LANDAS
Provider Other First Name:
CHERYL ANN
Provider Other Middle Name:
DEOCAMPO
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, MFTI, AMFT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1215143896
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/29/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3801 3RD ST STE 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94124-1409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-970-4000
Provider Business Mailing Address Fax Number:
415-970-3813

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3801 3RD ST STE 400
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-970-4000
Provider Business Practice Location Address Fax Number:
415-970-3813
Provider Enumeration Date:
05/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  LMFT107673 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com