Provider Demographics
NPI:1730427931
Name:LUND, MATTHEW H (MA, MFT)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:H
Last Name:LUND
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1683
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-6683
Mailing Address - Country:US
Mailing Address - Phone:925-451-0453
Mailing Address - Fax:
Practice Address - Street 1:913 SAN RAMON VALLEY BLVD
Practice Address - Street 2:SUITE 280
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4031
Practice Address - Country:US
Practice Address - Phone:925-451-0453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 48714106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist