Provider Demographics
NPI:1386681435
Name:MARTINEZ-ORNUM, JOSEPHINE (RN, FNP)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:MARTINEZ-ORNUM
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 KATHERINE AVE
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3176
Mailing Address - Country:US
Mailing Address - Phone:831-751-6222
Mailing Address - Fax:831-751-0692
Practice Address - Street 1:335 KATHERINE AVE
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3176
Practice Address - Country:US
Practice Address - Phone:831-751-6222
Practice Address - Fax:831-751-0692
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA378660163W00000X
CA14577363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA378660OtherMEDICAL LICENSE NUMBER
CA14577OtherNURSE PRACTITIONER CERTIF