Provider Demographics
NPI:1003517780
Name:BALESTRIERI-MARTINEZ, BERNADETTE MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:MARIE
Last Name:BALESTRIERI-MARTINEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 MEDICAL CENTER CT
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-6617
Mailing Address - Country:US
Mailing Address - Phone:619-502-4014
Mailing Address - Fax:
Practice Address - Street 1:751 MEDICAL CENTER CT
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6617
Practice Address - Country:US
Practice Address - Phone:619-502-4014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1257364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care