Individual
KELLY MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
915 54TH ST, OAKLAND, CA 94608-3142
(510) 879-5003
Mailing address
1710 139TH AVE, SAN LEANDRO, CA 94578-1660
(510) 390-3436
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
230250699
CA
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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