Doctor Name: | MONICA ELENA MARTINEZ |
NPI Number: | 1093052417 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | IMF 72530 |
Business Practice Address: | 11731 Telegraph Rd Pacific Clinicis Santa Fe Springs, CA - 906703675 |
Business Phone Number: | 6266276073 |
Business Fax Number: | |
Mailing Address: | 12922 Andy Dr, CERRITOS |
State: | CA |
Postal Code: | 907036066 |
Phone Number: | 6266276073 |
Fax Number: | |
NPI Enumeration Date: | 01/04/2013 |
NPI Last Update Date: | 02/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | IMF 72530 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |