| Doctor Name: | ALBERT MARTINEZ |
| NPI Number: | 1205960978 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | C.A.S. |
| License Number: | 4030 |
| Business Practice Address: | 565 Chaney St Lake Elsinore, CA - 925302722 |
| Business Phone Number: | 9516745354 |
| Business Fax Number: | 9516745227 |
| Mailing Address: | 565 Chaney St, LAKE ELSINORE |
| State: | CA |
| Postal Code: | 925302722 |
| Phone Number: | 9516745354 |
| Fax Number: | 9516745227 |
| NPI Enumeration Date: | 03/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 4030 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |