Provider Demographics
NPI:1659263556
Name:MARTIN-JENSEN, DANIELLE (SUDRC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MARTIN-JENSEN
Suffix:
Gender:F
Credentials:SUDRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 LA GRACIA CIR UNIT 207
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-1926
Mailing Address - Country:US
Mailing Address - Phone:805-712-5337
Mailing Address - Fax:
Practice Address - Street 1:1011 PACIFIC ST STE 200
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3600
Practice Address - Country:US
Practice Address - Phone:408-641-0387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)