Provider Demographics
NPI:1235843624
Name:MARTINEZ, NISHEA
Entity Type:Individual
Prefix:
First Name:NISHEA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 POTTLE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-3755
Mailing Address - Country:US
Mailing Address - Phone:408-656-2525
Mailing Address - Fax:
Practice Address - Street 1:714 POTTLE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-3755
Practice Address - Country:US
Practice Address - Phone:408-656-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No171400000XOther Service ProvidersHealth & Wellness Coach
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist