Healthcare Provider Details

I. General information

NPI: 1821943358
Provider Name (Legal Business Name): SHAWN MARTINEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 03/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 HARTNELL AVE
REDDING CA
96002-2312
US

IV. Provider business mailing address

2190 SINGLE TREE LN
REDDING CA
96002-4113
US

V. Phone/Fax

Practice location:
  • Phone: 530-245-8123
  • Fax: 530-605-4902
Mailing address:
  • Phone: 530-999-8575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: