OrganizationActive
An Individual Marriage and Relationship Therapy Corporation
NPI 1225765787 · Mental Health Clinic/Center (Including Community Mental Health Center) · San Mateo, CA
Provider details
- NPI number
- 1225765787
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jeanne Sutton, Ceo/Owner(650) 762-5284
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1015 Shoreline Dr
San Mateo, CA 94404-2047
Phone: (650) 762-5284
Approximate (ZIP-level) locationGet directions
Mailing address
1015 Shoreline Dr
San Mateo, CA 94404-2047
Registry dates
- Enumerated
- 2022-08-04
- Last updated
- 2022-08-04
- Certified
- 2022-08-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.