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NPI Code Detail

MEDICARE: MRS. BIANCA NICOLE MARTINEZ LMFT

MEDICARE:  MRS. BIANCA NICOLE MARTINEZ  LMFT
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
1106H00000XMarriage & Family Therapist118745CA

General Provider Information

NPI Number : 1659907038
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BIANCA NICOLE MARTINEZ LMFT
Provider Business Mailing Address
First Line : 365 E AVENIDA DE LOS ARBOLES # B83
Second Line :
City : THOUSAND OAKS
State : CA
Zip : 91360-2975
Country : US
Telephone Number : 626-344-0552
Fax Number : 626-550-4727
Provider Business Practice Location Address
First Line : 14448 E AMHERST ST
Second Line :
City : MOORPARK
State : CA
Zip : 93021-1302
Country : US
Telephone Number : 626-344-0552
Fax Number : 626-550-4727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2020
Last Update Date : 06/03/2026

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Directions to “ MRS. BIANCA NICOLE MARTINEZ LMFT” Practice Location

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