| Todd Black Licensed Marriage And Family Therapist Pc | |
|
120 N El Camino Real San Mateo CA 94401-2791 | |
| (650) 260-8564 | |
| Not Available |
| Full Name | Todd Black Licensed Marriage And Family Therapist Pc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 120 N El Camino Real, San Mateo, California |
| Authorized Official Name and Position | Todd C Black (PRESIDENT) |
| Authorized Official Contact | 6502608564 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Todd Black Licensed Marriage And Family Therapist Pc 120 N El Camino Real San Mateo CA 94401-2791 Ph: (650) 260-8564 | Todd Black Licensed Marriage And Family Therapist Pc 120 N El Camino Real San Mateo CA 94401-2791 Ph: (650) 260-8564 |
| NPI Number | 1528671674 |
|---|---|
| Provider Enumeration Date | 08/28/2020 |
| Last Update Date | 08/28/2020 |
| Certification Date | 08/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528671674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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