Provider Demographics
NPI:1790099034
Name:MARTINEZ, YVONNE CHAMALBIDE
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:CHAMALBIDE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12245 183RD ST
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-5955
Mailing Address - Country:US
Mailing Address - Phone:562-860-1940
Mailing Address - Fax:
Practice Address - Street 1:433 N 4TH ST STE 101
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4313
Practice Address - Country:US
Practice Address - Phone:323-722-8610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASPA 4472355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant