Individual
AMANDA DIANNE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, ATR
Contact information
Practice address
2000 ALAMEDA DE LAS PULGAS, SAN MATEO, CA 94403-1269
(650) 690-5372
Mailing address
2000 ALAMEDA DE LAS PULGAS, SAN MATEO, CA 94403-1269
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
AMFT126657
CA
106H00000X
Marriage & Family Therapist
Primary
LMFT151052
CA
106H00000X
Marriage & Family Therapist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/31/2020
Last updated
11/13/2024
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