Provider Demographics
NPI:1851619621
Name:MARTEJA, CHARLENE DELA CRUZ (MSW, LSW)
Entity Type:Individual
Prefix:MISS
First Name:CHARLENE
Middle Name:DELA CRUZ
Last Name:MARTEJA
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1785 E. SAHARA AVENUE
Mailing Address - Street 2:SUITE #445
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3733
Mailing Address - Country:US
Mailing Address - Phone:702-576-0533
Mailing Address - Fax:702-369-5605
Practice Address - Street 1:1785 E. SAHARA AVENUE
Practice Address - Street 2:SUITE #445
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3733
Practice Address - Country:US
Practice Address - Phone:702-576-0533
Practice Address - Fax:702-369-5605
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5761-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker