Provider Demographics
NPI:1003785957
Name:MARTINEZ, CECILIA VIRIDIANA
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:VIRIDIANA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CECILIA
Other - Middle Name:VIRIDIANA
Other - Last Name:MARTINEZ-AVILA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:35008 PALA TEMECULA RD # 470
Mailing Address - Street 2:
Mailing Address - City:PALA
Mailing Address - State:CA
Mailing Address - Zip Code:92059-2419
Mailing Address - Country:US
Mailing Address - Phone:858-361-9544
Mailing Address - Fax:
Practice Address - Street 1:35008 PALA TEMECULA RD # 470
Practice Address - Street 2:
Practice Address - City:PALA
Practice Address - State:CA
Practice Address - Zip Code:92059-2419
Practice Address - Country:US
Practice Address - Phone:858-361-9544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician