Provider Demographics
NPI:1790977023
Name:MARTINEZ, MARIA LUZ (MSW)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:LUZ
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:MARIA
Other - Middle Name:LUZ
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ACSW
Mailing Address - Street 1:1720 E 120TH ST
Mailing Address - Street 2:SAME
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90059-3052
Mailing Address - Country:US
Mailing Address - Phone:310-668-6008
Mailing Address - Fax:310-223-0914
Practice Address - Street 1:1720 E 120TH ST
Practice Address - Street 2:SAME
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059-3052
Practice Address - Country:US
Practice Address - Phone:310-668-6008
Practice Address - Fax:310-223-0914
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW205231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical