Provider Demographics
NPI:1205991932
Name:MARSHALL, JACINDA Y (PSY D)
Entity type:Individual
Prefix:DR
First Name:JACINDA
Middle Name:Y
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:DBA
Other - Middle Name:MARSHALL
Other - Last Name:PSYCHOTHERAPY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 411001
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94141-1001
Mailing Address - Country:US
Mailing Address - Phone:415-412-5742
Mailing Address - Fax:
Practice Address - Street 1:870 MARKET ST
Practice Address - Street 2:SUITE 819
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3099
Practice Address - Country:US
Practice Address - Phone:415-412-5742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 24439103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical