Provider Demographics
NPI:1437346921
Name:MARTINEZ, HECTOR GERARDO (MSW)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:GERARDO
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 INDUSTRY WAY
Mailing Address - Street 2:SUITE C
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-4024
Mailing Address - Country:US
Mailing Address - Phone:310-667-4070
Mailing Address - Fax:310-667-4070
Practice Address - Street 1:2620 INDUSTRY WAY
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-4024
Practice Address - Country:US
Practice Address - Phone:310-667-4070
Practice Address - Fax:310-667-4070
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW63880101YM0800X
CAASW97927101YM0800X
CA24282104100000X
CALCSW1030331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker