Provider Demographics
NPI:1538396882
Name:MARTINEZ GUTIERREZ, JOSE CARLOS (LMFT)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:CARLOS
Last Name:MARTINEZ GUTIERREZ
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 N U ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93701-2438
Mailing Address - Country:US
Mailing Address - Phone:916-202-2502
Mailing Address - Fax:
Practice Address - Street 1:153 N U ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2438
Practice Address - Country:US
Practice Address - Phone:916-202-2502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-14
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA92611106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist