Provider Demographics
NPI:1003610411
Name:MARTINEZ, VANESSA NASHAY (BEHAVIORAL TECH)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:NASHAY
Last Name:MARTINEZ
Suffix:
Gender:
Credentials:BEHAVIORAL TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 COORS BYP NW APT 1214
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4091
Mailing Address - Country:US
Mailing Address - Phone:505-363-4630
Mailing Address - Fax:
Practice Address - Street 1:10001 COORS BYP NW APT 1214
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4091
Practice Address - Country:US
Practice Address - Phone:505-363-4630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician