Provider Demographics
NPI:1376112144
Name:MARTINEZ, VILMA MARGARITA
Entity Type:Individual
Prefix:
First Name:VILMA
Middle Name:MARGARITA
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 1:146 MCALLISTER ST APT 403
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4998
Mailing Address - Country:US
Mailing Address - Phone:415-539-8775
Mailing Address - Fax:
Practice Address - Street 1:433 TURK ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3329
Practice Address - Country:US
Practice Address - Phone:415-928-7800
Practice Address - Fax:415-928-3710
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN190282164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse