Provider Demographics
NPI:1316485790
Name:MARTHA L. CRUZ LMFT
Entity type:Organization
Organization Name:MARTHA L. CRUZ LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE/FAMILY THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:LAURA
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:559-226-5397
Mailing Address - Street 1:4747 N 1ST ST
Mailing Address - Street 2:SUITE 119
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-0563
Mailing Address - Country:US
Mailing Address - Phone:559-226-5397
Mailing Address - Fax:559-226-5324
Practice Address - Street 1:4747 N 1ST ST
Practice Address - Street 2:SUITE 119
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-0563
Practice Address - Country:US
Practice Address - Phone:559-226-5397
Practice Address - Fax:559-226-5324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT48397251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health