Provider Demographics
NPI:1811232325
Name:MARTINEZ, LIZETH
Entity Type:Individual
Prefix:
First Name:LIZETH
Middle Name:
Last Name:MARTINEZ
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 1:1546 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2841
Mailing Address - Country:US
Mailing Address - Phone:707-253-0123
Mailing Address - Fax:707-253-8118
Practice Address - Street 1:1546 1ST ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2841
Practice Address - Country:US
Practice Address - Phone:707-253-0123
Practice Address - Fax:707-253-8118
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist