Healthcare Provider Details

I. General information

NPI: 1841145521
Provider Name (Legal Business Name): ZACHARY MARTINEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E OCEAN BLVD STE 330
LONG BEACH CA
90802-5052
US

IV. Provider business mailing address

7266 ALTARI PL
RANCHO CUCAMONGA CA
91701-8545
US

V. Phone/Fax

Practice location:
  • Phone: 562-432-0020
  • Fax:
Mailing address:
  • Phone: 909-204-1788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number159695
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: