Provider Demographics
NPI:1487411765
Name:MARLO, HELEN LOUISE (PHD)
Entity type:Individual
Prefix:DR
First Name:HELEN
Middle Name:LOUISE
Last Name:MARLO
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 1:205 DE ANZA BLVD # 138
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-3989
Mailing Address - Country:US
Mailing Address - Phone:650-579-4499
Mailing Address - Fax:
Practice Address - Street 1:101 S SAN MATEO DR STE 300
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3844
Practice Address - Country:US
Practice Address - Phone:650-579-4499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15318103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical