Provider Demographics
NPI:1003434788
Name:MARTI, WENDY
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:MARTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1396 MARINOVICH WAY
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-5738
Mailing Address - Country:US
Mailing Address - Phone:650-814-4133
Mailing Address - Fax:
Practice Address - Street 1:1396 MARINOVICH WAY
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-5738
Practice Address - Country:US
Practice Address - Phone:650-814-4133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health