Provider Demographics
NPI:1235778671
Name:MARTINEZ, TERESA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:MARTINEZ
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 1:7373 UNIVERSITY AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-0523
Mailing Address - Country:US
Mailing Address - Phone:619-832-9970
Mailing Address - Fax:
Practice Address - Street 1:2928 JEFFERSON ST STE 100
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2374
Practice Address - Country:US
Practice Address - Phone:760-637-9996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician