Doctor Name: | DR. MARTHA CRAVENS |
NPI Number: | 1063656148 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | PSY24041 |
Business Practice Address: | 350 2nd St Suite 1 Los Altos, CA - 940223695 |
Business Phone Number: | 6505046781 |
Business Fax Number: | |
Mailing Address: | 350 2nd St, Suite 1 LOS ALTOS |
State: | CA |
Postal Code: | 940413602 |
Phone Number: | 6505046781 |
Fax Number: | |
NPI Enumeration Date: | 04/21/2009 |
NPI Last Update Date: | 05/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY24041 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |