Provider Demographics
NPI:1518380286
Name:MARTINEZ, RACHEL CASSANDRA (BA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:CASSANDRA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 LIPAN ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80260-4912
Mailing Address - Country:US
Mailing Address - Phone:303-412-3960
Mailing Address - Fax:303-412-3344
Practice Address - Street 1:7373 BIRCH ST
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-1446
Practice Address - Country:US
Practice Address - Phone:303-412-3960
Practice Address - Fax:303-412-3344
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC 0103537101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)