Provider Demographics
NPI:1033578919
Name:MARTINEZ, CHRISTINA ROSE
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ROSE
Last Name:MARTINEZ
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 1:3401 QUEBEC ST STE 8000
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-2330
Mailing Address - Country:US
Mailing Address - Phone:720-640-6522
Mailing Address - Fax:
Practice Address - Street 1:3401 QUEBEC ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-2322
Practice Address - Country:US
Practice Address - Phone:720-925-1214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-19
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0000959101YA0400X
AK138809101YP2500X
COLPC.0014879101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)