Provider Demographics
NPI:1508660473
Name:MARTINEZ, ANA BEATRIZ
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:BEATRIZ
Last Name:MARTINEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18719 STRATHERN ST
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-1222
Mailing Address - Country:US
Mailing Address - Phone:818-482-6797
Mailing Address - Fax:
Practice Address - Street 1:18719 STRATHERN ST
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-1222
Practice Address - Country:US
Practice Address - Phone:818-482-6797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102956106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist