Provider Demographics
NPI:1922873587
Name:MARTIN-AYONG, PRINCESS (MSN, AGNP-C)
Entity Type:Individual
Prefix:MRS
First Name:PRINCESS
Middle Name:
Last Name:MARTIN-AYONG
Suffix:
Gender:F
Credentials:MSN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 E 21ST ST UNIT 127
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-5954
Mailing Address - Country:US
Mailing Address - Phone:562-507-6451
Mailing Address - Fax:
Practice Address - Street 1:2001 E 21ST ST UNIT 127
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-5954
Practice Address - Country:US
Practice Address - Phone:562-507-6451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAG11230039363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health