Provider Demographics
NPI:1154454056
Name:MARTINEZ, ARIADNA G
Entity Type:Individual
Prefix:
First Name:ARIADNA
Middle Name:G
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 1:8946 ARLINGDALE WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-3353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:395 BALLANTYNE ST
Practice Address - Street 2:#365
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3922
Practice Address - Country:US
Practice Address - Phone:619-588-3653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor