Krystina Lorraine Martinez | Moreno Valley, CA • PECOS Search

Krystina Lorraine Martinez

Behavior Technician

Behavioral Health & Social Service Providers

24081 Sandy Glade Ave, Moreno Valley, CA 92557-5529

(916) 869-2416 (909) 831-1030

PECOS Enrollment

Based on the most recent information from CMS, provider Krystina Lorraine Martinez does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1730759929
Provider Type
Individual
Full Name
Martinez, Krystina Lorraine
Title
Mrs.

Gender
Female
Sole Proprietor
No
Enumeration Date
6/29/2021
Last Updated
6/29/2021

Contact Information

Practice Location

24081 Sandy Glade Ave, Moreno Valley, CA 92557-5529

Unlisted Fax

Mailing Location

2874 Acacia Ave, San Bernardino, CA 92405-3317

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer