MEDICARE: KRISTIN MARGARET MARTINEZ LMFT #90136

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LMFT #90136	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	#95-2633765	OTHER	CA	MEDI-CAL

General Provider Information

NPI Number	:	1619249414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN MARGARET MARTINEZ LMFT #90136

Provider Business Mailing Address
First Line	:	30 VISTA TOSCANA
Second Line	:
City	:	LAKE ELSINORE
State	:	CA
Zip	:	92532-0215
Country	:	US
Telephone Number	:	951-291-8479
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 VISTA TOSCANA
Second Line	:
City	:	LAKE ELSINORE
State	:	CA
Zip	:	92532-0215
Country	:	US
Telephone Number	:	951-291-8479
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2012
Last Update Date	:	02/12/2026

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