Healthcare Provider Details

I. General information

NPI: 1447048699
Provider Name (Legal Business Name): VICTOR MARTINEZ PPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

634 W KAMALA ST
OXNARD CA
93033-3407
US

IV. Provider business mailing address

634 W KAMALA ST
OXNARD CA
93033-3407
US

V. Phone/Fax

Practice location:
  • Phone: 805-385-1557
  • Fax:
Mailing address:
  • Phone: 805-385-1557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: