Healthcare Provider Details

I. General information

NPI: 1316868771
Provider Name (Legal Business Name): ALICIA MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 CITADEL DR E STE 325
COLORADO SPRINGS CO
80909-5326
US

IV. Provider business mailing address

117 EVERETT DR
COLORADO SPRINGS CO
80911-1432
US

V. Phone/Fax

Practice location:
  • Phone: 888-609-9892
  • Fax:
Mailing address:
  • Phone: 719-722-0594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: