Provider Demographics
NPI:1508098989
Name:MARTINEZ, CECILIA SISON (OTR/L)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:SISON
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:752 AVENIDA LEON
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-7366
Mailing Address - Country:US
Mailing Address - Phone:760-453-6891
Mailing Address - Fax:760-295-8623
Practice Address - Street 1:785 GRAND AVE
Practice Address - Street 2:STE. 208
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2370
Practice Address - Country:US
Practice Address - Phone:760-453-6891
Practice Address - Fax:760-295-8623
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 3312225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist