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Organization
CHILD THERAPY INSTITUTE OF MARIN
Active
Organization
CHILD THERAPY INSTITUTE OF MARIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCELLE HOEFNAGELS (ADMINISTRATION)
(415) 456-7724
Entity
Organization
Contact information
Practice address
13925 SAN PABLO AVE #201, #203, #205, SAN PABLO, CA 94806-3676
(510) 778-8114
(510) 778-8255
Mailing address
1480 LINCOLN AVE STE 8, SAN RAFAEL, CA 94901-2085
(415) 456-7724
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/29/2021
Last updated
11/12/2024
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