Provider Demographics
NPI:1720086978
Name:MARTZEN, CYNTHIA LOUISE (MA)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LOUISE
Last Name:MARTZEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 E SPRUCE
Mailing Address - Street 2:SUITE #130
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720
Mailing Address - Country:US
Mailing Address - Phone:559-432-5973
Mailing Address - Fax:559-432-5973
Practice Address - Street 1:1351 E SPRUCE
Practice Address - Street 2:SUITE 130
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720
Practice Address - Country:US
Practice Address - Phone:559-432-5973
Practice Address - Fax:559-432-5973
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1171231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0011710Medicaid
CAAU0011710Medicaid