Provider Demographics
NPI:1487665923
Name:MARTINEZ, RICHARD ARRIOLA (LCSW)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ARRIOLA
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 OAKDALE ROAD SUITE 1120
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-0001
Mailing Address - Country:US
Mailing Address - Phone:209-573-7909
Mailing Address - Fax:209-526-1439
Practice Address - Street 1:1317 OAKDALE ROAD SUITE 1120
Practice Address - Street 2:1317 OAKDALE ROAD SUITE 1120
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-0001
Practice Address - Country:US
Practice Address - Phone:209-573-7909
Practice Address - Fax:209-526-1439
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA144241041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2224282Medicare ID - Type Unspecified
2224282Medicare UPIN