MEDICARE: MS. BREANA MARTIN 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
1	106H00000X	Marriage & Family Therapist	163961	CA

General Provider Information

NPI Number	:	1962048082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BREANA MARTIN LMFT

Provider Business Mailing Address
First Line	:	3924 BERNESE DR
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-6690
Country	:	US
Telephone Number	:	619-386-6220
Fax Number	:

Provider Business Practice Location Address
First Line	:	3924 BERNESE DR
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-6690
Country	:	US
Telephone Number	:	530-616-1036
Fax Number	:

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

Provider Enumeration Date	:	11/24/2019
Last Update Date	:	06/16/2026

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