Provider Demographics
NPI:1942435235
Name:BALDWIN, MARTHA BEATRIZ (LCSW)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:BEATRIZ
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:BEATRIZ
Other - Last Name:RUIZ-HAYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:384 E OLIVE AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-4051
Mailing Address - Country:US
Mailing Address - Phone:209-620-8464
Mailing Address - Fax:209-850-9411
Practice Address - Street 1:384 E OLIVE AVE STE 2
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-4051
Practice Address - Country:US
Practice Address - Phone:209-620-8464
Practice Address - Fax:209-850-9411
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW28157104100000X, 1041C0700X
CA281571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker