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NPI Code Detail

MEDICARE: GEORGINA MARTINEZ

MEDICARE: GEORGINA 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
1101YM0800XMental Health Counselor
2373H00000XDay Training/Habilitation Specialist
3172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1083002109
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGINA MARTINEZ
Provider Business Mailing Address
First Line : 10515 BALBOA BLVD STE 376
Second Line :
City : GRANADA HILLS
State : CA
Zip : 91344-6397
Country : US
Telephone Number : 818-488-3837
Fax Number : 818-360-8753
Provider Business Practice Location Address
First Line : 10605 BALBOA BLVD STE 100
Second Line :
City : GRANADA HILLS
State : CA
Zip : 91344-6367
Country : US
Telephone Number : 818-832-2400
Fax Number : 818-360-8753
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2014
Last Update Date : 02/10/2026

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Directions to “ GEORGINA MARTINEZ ” Practice Location

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