Provider Demographics
NPI:1497811871
Name:MARTINEZ-WARKENTIEN, DAMARIS (MFT)
Entity Type:Individual
Prefix:MS
First Name:DAMARIS
Middle Name:
Last Name:MARTINEZ-WARKENTIEN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 OAKLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-1243
Mailing Address - Country:US
Mailing Address - Phone:818-264-6284
Mailing Address - Fax:
Practice Address - Street 1:500 ESPLANADE DR
Practice Address - Street 2:SUITE 860
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2110
Practice Address - Country:US
Practice Address - Phone:818-264-6284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42556106H00000X
CA443269163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice