Provider Demographics
NPI:1780045963
Name:RIZO-MARTINEZ, SADIE JASMIN (RN)
Entity Type:Individual
Prefix:
First Name:SADIE
Middle Name:JASMIN
Last Name:RIZO-MARTINEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SADIE
Other - Middle Name:JASMIN
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:14309 YUKON AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-8501
Mailing Address - Country:US
Mailing Address - Phone:310-995-7627
Mailing Address - Fax:
Practice Address - Street 1:14309 YUKON AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-8501
Practice Address - Country:US
Practice Address - Phone:310-995-7627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA776453163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse