Provider Demographics
NPI:1114104338
Name:MARTINEZ SERRANO, MIRNA ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:MIRNA
Middle Name:ELIZABETH
Last Name:MARTINEZ SERRANO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9333 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-2812
Mailing Address - Country:US
Mailing Address - Phone:562-461-5481
Mailing Address - Fax:562-657-8595
Practice Address - Street 1:9333 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2812
Practice Address - Country:US
Practice Address - Phone:562-461-5481
Practice Address - Fax:562-657-8595
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator