MEDICARE: JESSICA VICTORIA MARTINEZ-ALMANZA MA

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

General Provider Information

NPI Number	:	1649964537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA VICTORIA MARTINEZ-ALMANZA MA

Provider Business Mailing Address
First Line	:	4424 N RAVENSWOOD AVE STE A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5803
Country	:	US
Telephone Number	:	312-219-4570
Fax Number	:

Provider Business Practice Location Address
First Line	:	4424 N RAVENSWOOD AVE STE A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5803
Country	:	US
Telephone Number	:	312-219-4570
Fax Number	:

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

Provider Enumeration Date	:	06/05/2023
Last Update Date	:	06/05/2023

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Directions to “ JESSICA VICTORIA MARTINEZ-ALMANZA MA” Practice Location

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