Provider Demographics
NPI:1730995291
Name:MARTINEZ, FRANK (MA, PPS)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MA, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 STANLEY DR
Mailing Address - Street 2:
Mailing Address - City:RIPON
Mailing Address - State:CA
Mailing Address - Zip Code:95366-3200
Mailing Address - Country:US
Mailing Address - Phone:209-599-7113
Mailing Address - Fax:209-599-2056
Practice Address - Street 1:1660 STANLEY DR
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:CA
Practice Address - Zip Code:95366-3200
Practice Address - Country:US
Practice Address - Phone:209-599-7113
Practice Address - Fax:209-599-2056
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA200166528101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool