Provider Demographics
NPI:1497026710
Name:MARTIN, JAMES W
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:MARTIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7026
Mailing Address - Street 2:2100 NAPA VALLEY HIGHWAY, BLDG M1 & M2
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558
Mailing Address - Country:US
Mailing Address - Phone:707-257-1460
Mailing Address - Fax:707-257-7524
Practice Address - Street 1:2100 NAPA VALLEY HWY,
Practice Address - Street 2:BLDG M1 & M2
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558
Practice Address - Country:US
Practice Address - Phone:707-257-1460
Practice Address - Fax:707-257-7524
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)