Provider Demographics
NPI:1760798813
Name:MARTINEZ, KARINA CAMPOY (PT)
Entity Type:Individual
Prefix:MISS
First Name:KARINA
Middle Name:CAMPOY
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4811 PETALUMA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90713-2815
Mailing Address - Country:US
Mailing Address - Phone:714-758-9500
Mailing Address - Fax:714-758-9555
Practice Address - Street 1:4811 PETALUMA AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90713-2815
Practice Address - Country:US
Practice Address - Phone:714-758-9500
Practice Address - Fax:714-758-9555
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT36618225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist