Provider Demographics
NPI:1497475792
Name:MARTINEZ, CLAUDIA ENA (PMHNP)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:ENA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 S IDAHO ST APT B
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-1443
Mailing Address - Country:US
Mailing Address - Phone:650-302-3586
Mailing Address - Fax:
Practice Address - Street 1:812 S IDAHO ST APT B
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-1443
Practice Address - Country:US
Practice Address - Phone:650-302-3586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program