Provider Demographics
NPI:1760951560
Name:MARTINEZ-GARCIA, YADIRA ALEXANDRA
Entity Type:Individual
Prefix:
First Name:YADIRA
Middle Name:ALEXANDRA
Last Name:MARTINEZ-GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4531 WHITECLIFF WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94803-2446
Mailing Address - Country:US
Mailing Address - Phone:510-332-9413
Mailing Address - Fax:
Practice Address - Street 1:110 RYAN INDUSTRIAL CT
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1592
Practice Address - Country:US
Practice Address - Phone:925-915-0610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-21
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician