MEDICARE: BIANCA NOELLE 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
1	101YM0800X	Mental Health Counselor	19674	CA

General Provider Information

NPI Number	:	1265025894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIANCA NOELLE MARTINEZ

Provider Business Mailing Address
First Line	:	50 W HILLCREST DR STE 206
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-4232
Country	:	US
Telephone Number	:	619-817-8914
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 W HILLCREST DR STE 206
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-4232
Country	:	US
Telephone Number	:	619-817-8914
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2021
Last Update Date	:	06/23/2025

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Directions to “ BIANCA NOELLE MARTINEZ ” Practice Location

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