Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PPSY30596 | CA |
Y | 103TC0700X | Clinical Psychologist | PPSY30596 | CA |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1124464987 |
---|---|
Provider Name | Dr. Roseann Teresa Martinez |
First Address | Monrovia, CA 91016-3427 |
Second Address | Monrovia, CA 91016-3427 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2013 |
Last Update Date | 24/01/2019 |