Provider Demographics
NPI:1386794238
Name:MARTINEZ-CHAVEZ, ADRIANA DEL CARMEN
Entity type:Individual
Prefix:MS
First Name:ADRIANA
Middle Name:DEL CARMEN
Last Name:MARTINEZ-CHAVEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1272 HAYES ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-1711
Mailing Address - Country:US
Mailing Address - Phone:707-346-4308
Mailing Address - Fax:
Practice Address - Street 1:1272 HAYES ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-1711
Practice Address - Country:US
Practice Address - Phone:707-346-4308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA701981041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA104100000XOtherSOCIAL WORKER
CA101Y00000XOtherCOUNSELOR
CA101YM0800XOtherMENTAL HEALTH