Provider Demographics
NPI:1518597434
Name:FARRELL, MARGARET HANNAH (LMFT)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:HANNAH
Last Name:FARRELL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:PEGGY
Other - Middle Name:HANNAH
Other - Last Name:FARRELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:942 PENINSULA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-1506
Mailing Address - Country:US
Mailing Address - Phone:650-740-3635
Mailing Address - Fax:
Practice Address - Street 1:1601 OLD BAYSHORE HWY STE 123
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1506
Practice Address - Country:US
Practice Address - Phone:415-841-2634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA117151106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist