Provider Demographics
NPI:1427882877
Name:MARTINEZ, MICHELLE (PPS)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14171 NEWLAND ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4503
Mailing Address - Country:US
Mailing Address - Phone:714-894-7281
Mailing Address - Fax:
Practice Address - Street 1:14171 NEWLAND ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4503
Practice Address - Country:US
Practice Address - Phone:714-894-7281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool