Provider Demographics
NPI:1437331840
Name:MARTINS, STEPHANIE (RN, BSN, PHN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MARTINS
Suffix:
Gender:F
Credentials:RN, BSN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:BLDG 11
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706
Mailing Address - Country:US
Mailing Address - Phone:714-562-1746
Mailing Address - Fax:714-562-1773
Practice Address - Street 1:1725 WEST 17TH STREET
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706
Practice Address - Country:US
Practice Address - Phone:714-834-7763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA674648163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health