Provider Demographics
NPI:1336412915
Name:MARTINEZ, FERNANDO W II (MA, BCBA, LBA)
Entity type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:W
Last Name:MARTINEZ
Suffix:II
Gender:M
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 SAN FELIPE ST STE 900
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1798
Mailing Address - Country:US
Mailing Address - Phone:602-663-9502
Mailing Address - Fax:425-491-7683
Practice Address - Street 1:10133 N 92ND ST STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4556
Practice Address - Country:US
Practice Address - Phone:602-663-9502
Practice Address - Fax:425-491-7683
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3435103K00000X
CA1-18-32500103K00000X
390200000X
AZ103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program