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General NPI Number Information
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NPI Number | 1558165993
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Entity Type | Individual
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Provider Name | TENNEY MARIE MARTIN ASW
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Gender | Female
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 1560 BROOKHOLLOW DR STE 106
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City | SANTA ANA
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State | CA
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Zip | 92705-5428
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Country | US
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Telephone | 714-766-2054
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Fax |
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Provider Business Mailing Address
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Address Line | 17595 HARVARD AVE STE C-920
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City | IRVINE
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State | CA
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Zip | 92614-8516
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Country | US
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Telephone | 805-286-8009
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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 | ASW123047
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License Number State | CA
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