Provider Demographics
NPI:1275118614
Name:ABABNEH, MARTHA (CNA)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:ABABNEH
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3826 MAXSON RD APT C
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-4600
Mailing Address - Country:US
Mailing Address - Phone:562-374-2258
Mailing Address - Fax:
Practice Address - Street 1:3826 MAXSON RD APT C
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-4600
Practice Address - Country:US
Practice Address - Phone:562-374-2258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01122010363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner