Provider Demographics
NPI:1558891416
Name:MARTIN, PIERRA (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:PIERRA
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PHD, LMFT
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 672142
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77267-2142
Mailing Address - Country:US
Mailing Address - Phone:424-326-3828
Mailing Address - Fax:424-204-0411
Practice Address - Street 1:9431 HAVEN AVE STE 100
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5879
Practice Address - Country:US
Practice Address - Phone:424-326-3828
Practice Address - Fax:424-204-0411
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78400106H00000X, 171M00000X
106H00000X
CA122285106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator