Provider Demographics
NPI:1053796433
Name:MARTINEZ, CHRISTOPHER FRANK (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:FRANK
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10522 SANTA GERTRUDES AVE APT 62
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2745
Mailing Address - Country:US
Mailing Address - Phone:626-242-5715
Mailing Address - Fax:
Practice Address - Street 1:7120 HAYVENHURST AVE
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3843
Practice Address - Country:US
Practice Address - Phone:800-930-5773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-15-18287103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst