Provider Demographics
NPI:1194566273
Name:MARTINEZ COLIN, KARINA (CMPSS)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:MARTINEZ COLIN
Suffix:
Gender:F
Credentials:CMPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 JOHNSTON ST APT 7
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-2789
Mailing Address - Country:US
Mailing Address - Phone:818-270-3224
Mailing Address - Fax:
Practice Address - Street 1:4099 N MISSION RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90032-2697
Practice Address - Country:US
Practice Address - Phone:323-221-1746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMPSS-WKCLFX175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist