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NPI Code Detail

MEDICARE: KIMBERLY MARTINEZ

MEDICARE: KIMBERLY MARTINEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1063188142
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY MARTINEZ
Provider Business Mailing Address
First Line : 16782 VON KARMAN AVE STE 11
Second Line :
City : IRVINE
State : CA
Zip : 92606-2417
Country : US
Telephone Number : 855-223-7123
Fax Number :
Provider Business Practice Location Address
First Line : 12409 W INDIAN SCHOOL RD STE B210
Second Line :
City : AVONDALE
State : AZ
Zip : 85392-9505
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2021
Last Update Date : 12/12/2025

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Directions to “ KIMBERLY MARTINEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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