Provider Demographics
NPI:1457483364
Name:MARTIN, HALIMAH (CNM)
Entity Type:Individual
Prefix:
First Name:HALIMAH
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:
Other - Last Name:PATIENCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:602 OLIVE SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-9649
Mailing Address - Country:US
Mailing Address - Phone:831-475-2814
Mailing Address - Fax:866-593-3489
Practice Address - Street 1:602 OLIVE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-9649
Practice Address - Country:US
Practice Address - Phone:831-475-2814
Practice Address - Fax:866-593-3489
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANMW1314367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGNMW00100Medicaid