Basic Information
| Provider Information | |||||||||
| NPI: | 1225330871 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CURRIE-MARTINEZ | ||||||||
| FirstName: | TARA | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 DAVIS DRIVE | ||||||||
| Address2: | |||||||||
| City: | BELMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507435883 | ||||||||
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| Practice Location | |||||||||
| Address1: | 31 TOWER ROAD | ||||||||
| Address2: | |||||||||
| City: | SAN MATEO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503125320 | ||||||||
| FaxNumber: | 6505722414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2010 | ||||||||
| LastUpdateDate: | 02/12/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCSW81340 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.