Healthcare Provider Details

I. General information

NPI: 1508029596
Provider Name (Legal Business Name): MALORIE MARTINEZ FELIX MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MALORIE MARTINEZ MFT

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 04/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2607 MYRTLE ST STE HEALTH
OAKLAND CA
94607-3415
US

IV. Provider business mailing address

2607 MYRTLE ST
OAKLAND CA
94607-3415
US

V. Phone/Fax

Practice location:
  • Phone: 510-835-1393
  • Fax: 510-835-2497
Mailing address:
  • Phone: 510-835-1393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number88535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: