Provider Demographics
NPI:1760733661
Name:MARTINEZ, ARLENE MARIBEL (MA)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:MARIBEL
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 E CUMBERLAND RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-3505
Mailing Address - Country:US
Mailing Address - Phone:213-293-5492
Mailing Address - Fax:
Practice Address - Street 1:1119 E CUMBERLAND RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-3505
Practice Address - Country:US
Practice Address - Phone:213-293-5492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT116299106H00000X
CAAMFT77913106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist