Provider Demographics
NPI:1992870315
Name:MARTIN DEL CAMPO, MICHELLE CANDACE (MA)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:CANDACE
Last Name:MARTIN DEL CAMPO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:CANDACE
Other - Last Name:MARTIN DEL CAMPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1098 SAN BENITO ST
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-4802
Mailing Address - Country:US
Mailing Address - Phone:408-921-6380
Mailing Address - Fax:
Practice Address - Street 1:1098 SAN BENITO ST
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-4802
Practice Address - Country:US
Practice Address - Phone:408-921-6380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty