Provider Demographics
NPI:1285953943
Name:PACHECO, MARTIN
Entity type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:
Last Name:PACHECO
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:MARTIN
Other - Middle Name:URBINA
Other - Last Name:PACHECO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6584 FALL RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-4015
Mailing Address - Country:US
Mailing Address - Phone:408-323-1849
Mailing Address - Fax:
Practice Address - Street 1:333 HEGENBERGER ROAD #600
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621
Practice Address - Country:US
Practice Address - Phone:510-383-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor