Provider Demographics
NPI:1326766544
Name:MARTIN, TONYIA CHRISTEENA ANNE
Entity Type:Individual
Prefix:
First Name:TONYIA
Middle Name:CHRISTEENA ANNE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TONYIA
Other - Middle Name:
Other - Last Name:DOYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:671 VISTA CT
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-4923
Mailing Address - Country:US
Mailing Address - Phone:559-362-7228
Mailing Address - Fax:
Practice Address - Street 1:1070 CONCORD AVE STE 200
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5647
Practice Address - Country:US
Practice Address - Phone:925-849-5087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program