Provider Demographics
NPI:1316474422
Name:MARTINEZ, DANA LEANN (CADC II, ICADC, IS)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:LEANN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:CADC II, ICADC, IS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2136 VERANO ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95838-4658
Mailing Address - Country:US
Mailing Address - Phone:916-704-6980
Mailing Address - Fax:
Practice Address - Street 1:310 HARRIS AVE STE A
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-3249
Practice Address - Country:US
Practice Address - Phone:916-929-6793
Practice Address - Fax:916-929-7411
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)