Provider Demographics
NPI:1982003000
Name:MARTIN, ANGELA CHRISTINE
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:CHRISTINE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SPRUCE STREET
Mailing Address - Street 2:
Mailing Address - City:GRIDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95948
Mailing Address - Country:US
Mailing Address - Phone:530-846-7309
Mailing Address - Fax:
Practice Address - Street 1:300 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GRIDLEY
Practice Address - State:CA
Practice Address - Zip Code:95948-2230
Practice Address - Country:US
Practice Address - Phone:530-846-7309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool