Provider Demographics
NPI:1154972966
Name:NAOMI C MARTIN, MARRIAGE AND FAMILY COUNSELING INC.
Entity type:Organization
Organization Name:NAOMI C MARTIN, MARRIAGE AND FAMILY COUNSELING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:COOPER
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:760-717-9405
Mailing Address - Street 1:2111 S EL CAMINO REAL # 30092054
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-9001
Mailing Address - Country:US
Mailing Address - Phone:760-717-9405
Mailing Address - Fax:
Practice Address - Street 1:2111 S EL CAMINO REAL # 30092054
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-9001
Practice Address - Country:US
Practice Address - Phone:760-717-9405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA48304OtherBOARD OF BEHAVIORAL SCIENCES