Provider Demographics
NPI:1598277857
Name:MARTINEZ, CINDY JEANETTE (NP-C)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:JEANETTE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6336 PASSONS BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-3355
Mailing Address - Country:US
Mailing Address - Phone:562-949-0965
Mailing Address - Fax:
Practice Address - Street 1:6336 PASSONS BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-3355
Practice Address - Country:US
Practice Address - Phone:562-949-0965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2023-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007853363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95007853OtherMEDICAL LICENSE
CAD1637535OtherCDL