Provider Demographics
NPI:1093902173
Name:MARTINEZ, LUCIA DEL CARMEN (LVN)
Entity Type:Individual
Prefix:MRS
First Name:LUCIA
Middle Name:DEL CARMEN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3126 N BRAWLEY AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-4633
Mailing Address - Country:US
Mailing Address - Phone:559-250-8411
Mailing Address - Fax:
Practice Address - Street 1:3126 N BRAWLEY AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-4633
Practice Address - Country:US
Practice Address - Phone:559-250-8411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN209957164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse