Provider Demographics
NPI:1033797253
Name:MARTINEZ, JEANNETTE ASHLEY (MFT)
Entity type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:ASHLEY
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 S CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-4709
Mailing Address - Country:US
Mailing Address - Phone:559-453-8050
Mailing Address - Fax:
Practice Address - Street 1:4812 E BUTLER AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-5014
Practice Address - Country:US
Practice Address - Phone:559-453-8050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist