Provider Demographics
NPI:1790809242
Name:MARTINEZ, MONICA (AA DEGREE)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:AA DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 S SEVENTH AVENUE
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-3211
Mailing Address - Country:US
Mailing Address - Phone:626-961-8971
Mailing Address - Fax:626-961-6685
Practice Address - Street 1:160 S 7TH AVE
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91746-3211
Practice Address - Country:US
Practice Address - Phone:626-961-8971
Practice Address - Fax:626-961-6685
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner