Provider Demographics
NPI:1780076737
Name:MARTINEZ, CIRILDA (MS)
Entity type:Individual
Prefix:
First Name:CIRILDA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CIRILDA
Other - Middle Name:
Other - Last Name:VALDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:6455 ORIZABA AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-3358
Mailing Address - Country:US
Mailing Address - Phone:213-610-5811
Mailing Address - Fax:
Practice Address - Street 1:12440 FIRESTONE BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-4366
Practice Address - Country:US
Practice Address - Phone:562-864-3722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-28
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF84639106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist