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General NPI Number Information
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NPI Number | 1184920878
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Entity Type | Organization
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Legal Business Name | JAIME MARTINEZ
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Dates
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Enumeration Date | 01/28/2011
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Last Update Date | 01/28/2011
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Provider Practice Location Address
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Address Line | 1911 WILLIAMS DR
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City | OXNARD
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State | CA
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Zip | 93036-2612
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Country | US
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Telephone | 805-981-9270
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Fax |
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Provider Business Mailing Address
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Address Line | 1911 WILLIAMS DR
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City | OXNARD
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State | CA
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Zip | 93036-2612
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH ASSOCIATE
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Name | MR. JAIME MARTINEZ
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Credential | B.A.
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Telephone | 805-889-7408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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