Individual
DR. FREDERICK HAROLD MARTIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
11301 WILSHIRE BLVD, 116B, LOS ANGELES, CA 90073-1003
(310) 478-3711
Mailing address
6084 ARMITOS DR, CAMARILLO, CA 93012-9368
(310) 466-8018
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
B1-0000500
DE
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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