| Izzo Marriage & Family Therapy Pc | |
|
55 W 5th Ave Apt 9a San Mateo CA 94402-2052 | |
| (650) 458-7737 | |
| Not Available |
| Full Name | Izzo Marriage & Family Therapy Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 55 W 5th Ave Apt 9a, San Mateo, California |
| Authorized Official Name and Position | Anna Izzo (CEO) |
| Authorized Official Contact | 6504587737 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Izzo Marriage & Family Therapy Pc 307 South B Street California CA 94401-4053 Ph: (650) 223-5605 | Izzo Marriage & Family Therapy Pc 55 W 5th Ave Apt 9a San Mateo CA 94402-2052 Ph: (650) 458-7737 |
| NPI Number | 1518557552 |
|---|---|
| Provider Enumeration Date | 01/23/2021 |
| Last Update Date | 08/16/2024 |
| Certification Date | 08/16/2024 |
| Medicare PECOS PAC ID | 5092249490 |
|---|---|
| Medicare Enrollment ID | O20241107002046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518557552 | NPI | - | NPPES |
| NPI | Other | 1629561816 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Anna Izzo |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1629561816 PECOS PAC ID: 6901330307 Enrollment ID: I20241107002233 |
| Provider Name | Yael Gonicman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1144759556 PECOS PAC ID: 4183158082 Enrollment ID: I20241114003683 |
| Provider Name | Dalton Wayne Huckaby |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1073263349 PECOS PAC ID: 5698209401 Enrollment ID: I20241114004403 |
| Provider Name | Marylou Torrez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1639836315 PECOS PAC ID: 3971037656 Enrollment ID: I20241118001997 |
| Provider Name | Claire Posel |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1184280877 PECOS PAC ID: 1557895232 Enrollment ID: I20241118002239 |
| Provider Name | Zoe Camp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447651559 PECOS PAC ID: 4385179076 Enrollment ID: I20241118003192 |
| Provider Name | Jennifer Fan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1841366804 PECOS PAC ID: 5698200251 Enrollment ID: I20241120001000 |
| Provider Name | Laura Purpura |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1982377537 PECOS PAC ID: 7517492028 Enrollment ID: I20241120004210 |
| Provider Name | Sara Kenney |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1316402456 PECOS PAC ID: 8729513080 Enrollment ID: I20241122001730 |
| Provider Name | Tara Ann Cronin |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1225107881 PECOS PAC ID: 7012442379 Enrollment ID: I20241122002078 |
| Provider Name | Suzanne Marie Dito |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1851984132 PECOS PAC ID: 8325574114 Enrollment ID: I20241203003380 |
| Provider Name | Soua Ly Moua |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1053442707 PECOS PAC ID: 3779011457 Enrollment ID: I20250108002816 |
| Provider Name | William Joseph Money |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801314299 PECOS PAC ID: 8426579897 Enrollment ID: I20250303001122 |
| Provider Name | Sohavani Mand |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1285107532 PECOS PAC ID: 5991226128 Enrollment ID: I20250304004103 |
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