Individual
LIDIA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1151 DOVE ST, NEWPORT BEACH, CA 92660-2840
(949) 630-8290
Mailing address
1151 DOVE ST, NEWPORT BEACH, CA 92660-2840
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/25/2022
Last updated
05/25/2022
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