Individual
CARLOS MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4718 W 136TH ST, HAWTHORNE, CA 90250-5738
(310) 218-6847
Mailing address
4718 W 136TH ST, HAWTHORNE, CA 90250-5738
(310) 218-6847
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
105900
CA
Other
Enumeration date
04/24/2018
Last updated
04/24/2018
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