Provider Demographics
NPI:1376821124
Name:MARTINEZ, NANCY C (LCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:C
Last Name:MARTINEZ
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 1:695 S VERMONT AVE
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-1349
Mailing Address - Country:US
Mailing Address - Phone:213-480-3480
Mailing Address - Fax:213-252-8878
Practice Address - Street 1:695 S VERMONT AVE
Practice Address - Street 2:9TH FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-1349
Practice Address - Country:US
Practice Address - Phone:213-480-3480
Practice Address - Fax:213-252-8878
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS278591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical