Provider Demographics
NPI:1235902784
Name:MARTINEZ, MELYNA ROCHELLE
Entity Type:Individual
Prefix:
First Name:MELYNA
Middle Name:ROCHELLE
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 1:43643 DEGLET NOOR ST
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-2323
Mailing Address - Country:US
Mailing Address - Phone:760-902-5501
Mailing Address - Fax:
Practice Address - Street 1:43643 DEGLET NOOR ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-2323
Practice Address - Country:US
Practice Address - Phone:760-902-5501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist