Provider Demographics
NPI:1811871635
Name:MARTINEZ GARCIA, LAURA VICTORIA (PPS)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:VICTORIA
Last Name:MARTINEZ GARCIA
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3428 TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-4040
Mailing Address - Country:US
Mailing Address - Phone:619-395-6020
Mailing Address - Fax:
Practice Address - Street 1:2359 TRUXTUN RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-6049
Practice Address - Country:US
Practice Address - Phone:619-395-6020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool