Provider Demographics
NPI:1740733534
Name:ARREOLA CAMACHO, MARTIN (BA)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:ARREOLA CAMACHO
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 CHABLIS WAY
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:CA
Mailing Address - Zip Code:93926-9237
Mailing Address - Country:US
Mailing Address - Phone:831-800-7530
Mailing Address - Fax:831-784-0715
Practice Address - Street 1:1270 NATIVIDAD RD
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3144
Practice Address - Country:US
Practice Address - Phone:831-444-5144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101Y00000XBehavioral Health & Social Service ProvidersCounselor