Provider Demographics
NPI:1871650523
Name:MARTINEZ, CHRISTINE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 31396
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-8396
Mailing Address - Country:US
Mailing Address - Phone:925-939-8585
Mailing Address - Fax:925-933-2709
Practice Address - Street 1:2405 SHADELANDS DR
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2444
Practice Address - Country:US
Practice Address - Phone:925-939-8585
Practice Address - Fax:925-933-2709
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17487363AS0400X
CAPA17487363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant