Provider Demographics
NPI:1881313260
Name:MARTINEZ, ASHLEIGH M (ASW)
Entity type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:M
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:ASHLEIGH
Other - Middle Name:MADISON
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2642 DECKER WAY
Mailing Address - Street 2:
Mailing Address - City:W SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-4513
Mailing Address - Country:US
Mailing Address - Phone:719-749-8105
Mailing Address - Fax:
Practice Address - Street 1:455 1ST ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-4023
Practice Address - Country:US
Practice Address - Phone:530-662-2211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-26
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA126652104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program