Provider Demographics
NPI:1568595445
Name:MARTINEZ, DIANNA Y
Entity Type:Individual
Prefix:MS
First Name:DIANNA
Middle Name:Y
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:YOLLANDA
Other - Middle Name:D
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:512 S OAK KNOLL AVE
Mailing Address - Street 2:#3
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-3438
Mailing Address - Country:US
Mailing Address - Phone:626-862-3546
Mailing Address - Fax:
Practice Address - Street 1:513 E LIME AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-2982
Practice Address - Country:US
Practice Address - Phone:626-358-9092
Practice Address - Fax:626-358-9617
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner