Provider Demographics
NPI:1215143896
Name:MARTIN-DEOCAMPO, CHERYL ANN (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:ANN
Last Name:MARTIN-DEOCAMPO
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:MRS
Other - First Name:CHERYL ANN
Other - Middle Name:DEOCAMPO
Other - Last Name:LANDAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, MFTI, AMFT
Mailing Address - Street 1:3801 3RD ST STE 400
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124-1409
Mailing Address - Country:US
Mailing Address - Phone:415-970-4000
Mailing Address - Fax:415-970-3813
Practice Address - Street 1:3801 3RD ST STE 400
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124
Practice Address - Country:US
Practice Address - Phone:415-970-4000
Practice Address - Fax:415-970-3813
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT107673106H00000X
CA68317106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist