Healthcare Provider Details

I. General information

NPI: 1831669480
Provider Name (Legal Business Name): ADRIANA NICOLE MARTINEZ SESE ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2018
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 N AURORA ST STE 1
STOCKTON CA
95202-2276
US

IV. Provider business mailing address

1212 N CALIFORNIA ST
STOCKTON CA
95202-1552
US

V. Phone/Fax

Practice location:
  • Phone: 94-689-3702
  • Fax:
Mailing address:
  • Phone: 209-468-8786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number120727
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: