Healthcare Provider Details

I. General information

NPI: 1114605037
Provider Name (Legal Business Name): DIANA MARTINEZ M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIANA MARTINEZ DIANA MARTINEZ, M.S.

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E 13TH ST
MERCED CA
95341-6211
US

IV. Provider business mailing address

5257 E TOWNSEND AVE
FRESNO CA
93727-5963
US

V. Phone/Fax

Practice location:
  • Phone: 209-381-6800
  • Fax:
Mailing address:
  • Phone: 805-204-1307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number140833
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: