Provider Demographics
NPI:1326293648
Name:MARTIN, AMY SUZANNE (CADCII)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:SUZANNE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307-1051
Mailing Address - Country:US
Mailing Address - Phone:661-861-6111
Mailing Address - Fax:661-861-6161
Practice Address - Street 1:1100 UNION AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-1051
Practice Address - Country:US
Practice Address - Phone:661-861-6111
Practice Address - Fax:661-861-6161
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)