Doctor Name: | MR. JOHN ANTHONY MARTINEZ |
NPI Number: | 1013036672 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.C.S.W. |
License Number: | LCS 13683 |
Business Practice Address: | 6651a Balboa Blvd Lausd School Mental Health Clinic Van Nuys, CA - 914065529 |
Business Phone Number: | 8189972640 |
Business Fax Number: | |
Mailing Address: | 6651a Balboa Blvd, Lausd School Mental Health Clinic VAN NUYS |
State: | CA |
Postal Code: | 914065529 |
Phone Number: | 8189972640 |
Fax Number: | |
NPI Enumeration Date: | 03/28/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS 13683 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |