Provider Demographics
NPI:1649756529
Name:MARTINEZ, AMANDA CAROL (BCBA)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:CAROL
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6316 MARIPOSA AVE APT 20
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-6657
Mailing Address - Country:US
Mailing Address - Phone:916-947-0454
Mailing Address - Fax:
Practice Address - Street 1:6316 MARIPOSA AVE APT 20
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-6657
Practice Address - Country:US
Practice Address - Phone:916-947-0454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CA1-25-80534103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician