Provider Demographics
NPI:1376256958
Name:MARTINEZ, KRISTINA MONIQUE (CPT)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MONIQUE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 GIUSEPPE CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307-5572
Mailing Address - Country:US
Mailing Address - Phone:805-703-6316
Mailing Address - Fax:
Practice Address - Street 1:1008 GIUSEPPE CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-5572
Practice Address - Country:US
Practice Address - Phone:805-703-6316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-29
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01007451246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy