Provider Demographics
NPI:1497971220
Name:BARTZEN, MARTHA E (RN, PHN)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:E
Last Name:BARTZEN
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9327 GOLONDRINA DR
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5647
Mailing Address - Country:US
Mailing Address - Phone:619-463-3763
Mailing Address - Fax:
Practice Address - Street 1:855 E MADISON AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3819
Practice Address - Country:US
Practice Address - Phone:619-441-6503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA384007163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health