MEDICARE: KAYLY ANN MARTINEZ

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1780546614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLY ANN MARTINEZ

Provider Business Mailing Address
First Line	:	21200 KITTRIDGE ST APT 3215
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91303-3066
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18226 VENTURA BLVD STE 202
Second Line	:
City	:	TARZANA
State	:	CA
Zip	:	91356-4246
Country	:	US
Telephone Number	:	818-975-8097
Fax Number	:

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

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ KAYLY ANN MARTINEZ ” Practice Location

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