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NPI 1659281129

NPI 1659281129 : ALEXANDRA MARTINEZ : RANCHO CUCAMONGA, CA

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General NPI Number Information
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    NPI Number           |    1659281129
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    Entity Type          |    Individual 
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    Provider Name        |    ALEXANDRA MARTINEZ
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/08/2026
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    Last Update Date     |    09/08/2026
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Provider Practice Location Address
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    Address Line         |    11799 SEBASTIAN WAY STE 103 
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    City                 |    RANCHO CUCAMONGA
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    State                |    CA
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    Zip                  |    91730-0708
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    Country              |    US
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    Telephone            |    909-710-0017
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    77777 COUNTRY CLUB DR APT 223 
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    City                 |    PALM DESERT
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    State                |    CA
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    Zip                  |    92211-0464
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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    |    
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    Y6588540
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    License Number State |    CA
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