Provider Demographics
NPI:1740687185
Name:MARTINEZ, LEONARDO A (LCSW, CADCII)
Entity type:Individual
Prefix:MR
First Name:LEONARDO
Middle Name:A
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:LCSW, CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 OXBUROUGH DR
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3500
Mailing Address - Country:US
Mailing Address - Phone:925-405-7653
Mailing Address - Fax:
Practice Address - Street 1:148 OXBUROUGH DR
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3500
Practice Address - Country:US
Practice Address - Phone:925-405-7653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-01
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACADCA I42040814101YA0400X
CA1021121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)