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General NPI Number Information
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NPI Number | 1548627995
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Entity Type | Individual
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Provider Name | REBECCA A MARTIN PSYD
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Gender | Female
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 24511 W JAYNE AVE
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City | COALINGA
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State | CA
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Zip | 93210-9503
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Country | US
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Telephone | 559-577-5801
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Fax |
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Provider Business Mailing Address
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Address Line | 24511 W JAYNE AVE
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City | COALINGA
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State | CA
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Zip | 93210-9503
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Country | US
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Telephone | 559-577-5801
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 27595
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PSY27595
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License Number State | CA
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