Individual
CASEY ANNETTE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 CHERRY LN STE 101, MANTECA, CA 95337-4311
(209) 647-6200
Mailing address
302 CHERRY LN STE 101, MANTECA, CA 95337-4311
(209) 647-6200
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-LCEJTP
CA
Other
Enumeration date
03/21/2023
Last updated
07/25/2023
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