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General NPI Number Information
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NPI Number | 1548460074
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Entity Type | Individual
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Provider Name | JOHANNA MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | 161 W VICTORIA ST
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City | LONG BEACH
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State | CA
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Zip | 90805-2175
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Country | US
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Telephone | 323-605-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 9733 DEARBORN AVE
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City | SOUTH GATE
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State | CA
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Zip | 90280-4301
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Country | US
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Telephone | 323-249-9363
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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