Provider Demographics
NPI:1932442845
Name:AVILA-MARTINEZ, LUCIA (LMFT)
Entity Type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:AVILA-MARTINEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 E CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-3642
Mailing Address - Country:US
Mailing Address - Phone:559-600-1033
Mailing Address - Fax:559-600-1101
Practice Address - Street 1:142 E CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-3642
Practice Address - Country:US
Practice Address - Phone:559-600-1033
Practice Address - Fax:559-600-1101
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT115028106H00000X
CAIMF88708106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist