Provider Demographics
NPI:1841326733
Name:MARTINEZ, KATYA EVELYN (MA SOCIAL WORK)
Entity type:Individual
Prefix:MISS
First Name:KATYA
Middle Name:EVELYN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MA SOCIAL WORK
Other - Prefix:MISS
Other - First Name:KATYA
Other - Middle Name:
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA SOCIAL WORK
Mailing Address - Street 1:1900 E 4TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3910
Mailing Address - Country:US
Mailing Address - Phone:714-835-4660
Mailing Address - Fax:
Practice Address - Street 1:1900 E 4TH ST FL 2
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3910
Practice Address - Country:US
Practice Address - Phone:714-835-4660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA296331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical