Provider Demographics
NPI:1548340235
Name:FOLEY, MARILYN JANE (PHD)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:JANE
Last Name:FOLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1802
Mailing Address - Country:US
Mailing Address - Phone:650-634-9896
Mailing Address - Fax:650-634-0436
Practice Address - Street 1:2000 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1802
Practice Address - Country:US
Practice Address - Phone:650-634-9896
Practice Address - Fax:650-634-0436
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18318103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical