Provider Demographics
NPI:1447401815
Name:MARIN, MILITZA
Entity Type:Individual
Prefix:MS
First Name:MILITZA
Middle Name:
Last Name:MARIN
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 1:15650 DEVONSHIRE ST STE 212
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-7245
Mailing Address - Country:US
Mailing Address - Phone:818-798-8520
Mailing Address - Fax:818-217-4341
Practice Address - Street 1:11239 TAMPA AVE STE 206
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91326-3781
Practice Address - Country:US
Practice Address - Phone:818-798-8520
Practice Address - Fax:818-217-4341
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT51490106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty