Individual
MS. ANDREA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT 146070
Contact information
Practice address
840 N AVENUE 66, LOS ANGELES, CA 90042-1508
(626) 395-7100
Mailing address
840 N AVENUE 66, LOS ANGELES, CA 90042-1508
(626) 395-7100
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
122877
CA
106H00000X
Marriage & Family Therapist
Primary
146070
CA
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01536011
MEDI-CAL
CA
Enumeration date
11/04/2019
Last updated
04/15/2024
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