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General NPI Number Information
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NPI Number | 1083080436
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Entity Type | Individual
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Provider Name | MAYRA PATRICIA MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 6080 CENTER DR FL 6
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City | LOS ANGELES
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State | CA
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Zip | 90045-9205
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Country | US
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Telephone | 310-692-4841
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Fax |
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Provider Business Mailing Address
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Address Line | 18017 CHATSWORTH ST # 17
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City | GRANADA HILLS
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State | CA
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Zip | 91344-5608
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Country | US
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Telephone | 818-839-1762
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 101464
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License Number State | CA
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