Provider Demographics
NPI:1245771633
Name:MARTINEZ, BROOKE (MS LMFT)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:2275 S MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-5303
Mailing Address - Country:US
Mailing Address - Phone:951-279-3222
Mailing Address - Fax:951-279-5222
Practice Address - Street 1:240 SHADY LANE DR
Practice Address - Street 2:
Practice Address - City:WADENA
Practice Address - State:MN
Practice Address - Zip Code:56482-3093
Practice Address - Country:US
Practice Address - Phone:182-319-6008
Practice Address - Fax:218-632-6583
Is Sole Proprietor?:No
Enumeration Date:2017-03-17
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health