Provider Demographics
NPI:1639924897
Name:MARTINEZ, BREAYN (SUD COUNSELOR)
Entity type:Individual
Prefix:
First Name:BREAYN
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:SUD COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1147 HARTNELL AVE
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-2113
Mailing Address - Country:US
Mailing Address - Phone:530-222-7213
Mailing Address - Fax:
Practice Address - Street 1:1261 OAKDALE LN
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0724
Practice Address - Country:US
Practice Address - Phone:530-917-1296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)