1225306236 NPI number — CHRISTOPHER RAMON MARTINEZ

Table of content: MR. ALBERT FRICHEL MORENO LMFT, LPC, LISAC,MAC (NPI 1255481388)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225306236 NPI number — CHRISTOPHER RAMON MARTINEZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARTINEZ
Provider First Name:
CHRISTOPHER
Provider Middle Name:
RAMON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MARTINEZ
Provider Other First Name:
CHRIS
Provider Other Middle Name:
RAMON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1225306236
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/05/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1000
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93302-1000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-868-6601
Provider Business Mailing Address Fax Number:
661-868-6666

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2151 COLLEGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-868-8123
Provider Business Practice Location Address Fax Number:
661-868-8087
Provider Enumeration Date:
12/05/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)