Healthcare Provider Details

I. General information

NPI: 1366118481
Provider Name (Legal Business Name): GLORIA MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 PEACH DR
SALINAS CA
93901-3710
US

IV. Provider business mailing address

35 CHESWICK CIR
SALINAS CA
93906-5065
US

V. Phone/Fax

Practice location:
  • Phone: 831-753-6001
  • Fax:
Mailing address:
  • Phone: 831-206-5289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number11230
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11230
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: