Provider Demographics
NPI:1295352631
Name:MARTINEZ DEL CASTILLO, DESIREE CHRISTINE (LMFT)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:CHRISTINE
Last Name:MARTINEZ DEL CASTILLO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 POLLASKY AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-1159
Mailing Address - Country:US
Mailing Address - Phone:559-203-3775
Mailing Address - Fax:
Practice Address - Street 1:4148 TOWN CENTER BLVD.
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636
Practice Address - Country:US
Practice Address - Phone:559-664-4000
Practice Address - Fax:559-675-5224
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA117105106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist