Provider Demographics
NPI:1457404105
Name:MARTIN, NAOMI CECLIA
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:CECLIA
Last Name:MARTIN
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 1:35 RODGERS ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-3048
Mailing Address - Country:US
Mailing Address - Phone:707-647-3389
Mailing Address - Fax:
Practice Address - Street 1:35 RODGERS ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-3048
Practice Address - Country:US
Practice Address - Phone:707-647-3389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor