Provider Demographics
NPI:1740318450
Name:MARTINEZ, GIOVANNI M (ADMINISTRATOR ASSIST)
Entity type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:M
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:ADMINISTRATOR ASSIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154A CAPP ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-1210
Mailing Address - Country:US
Mailing Address - Phone:415-826-6774
Mailing Address - Fax:415-826-6774
Practice Address - Street 1:154A CAPP ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1210
Practice Address - Country:US
Practice Address - Phone:415-826-6767
Practice Address - Fax:415-826-6774
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No172V00000XOther Service ProvidersCommunity Health Worker