Healthcare Provider Details

I. General information

NPI: 1407354822
Provider Name (Legal Business Name): BRITNIE MARTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2018
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 SISK RD STE 8
MODESTO CA
95356-0535
US

IV. Provider business mailing address

PO BOX 771
TURLOCK CA
95381-0771
US

V. Phone/Fax

Practice location:
  • Phone: 209-663-2003
  • Fax:
Mailing address:
  • Phone: 209-645-2338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: