Individual
LINDSEY LICETH MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24028 LAKE DRIVE, CRESTLINE, CA 92325
(909) 338-3222
Mailing address
PO BOX 4644, BLUE JAY, CA 92317-4644
(909) 648-6034
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
CA
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
04/09/2024
Last updated
09/24/2025
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