Provider Demographics
NPI:1205904323
Name:MARTINEZ, ABEL SALVATIERRA (MA MHRS)
Entity type:Individual
Prefix:MR
First Name:ABEL
Middle Name:SALVATIERRA
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MA MHRS
Other - Prefix:MR
Other - First Name:ABEL
Other - Middle Name:SALVATIERRA
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMFT
Mailing Address - Street 1:232 E GISH RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-4706
Mailing Address - Country:US
Mailing Address - Phone:408-876-4159
Mailing Address - Fax:408-453-9064
Practice Address - Street 1:232 E GISH RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-4706
Practice Address - Country:US
Practice Address - Phone:408-876-4159
Practice Address - Fax:408-453-9064
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA113157106H00000X
CAAMFT113157106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6335Medicare UPIN