Provider Demographics
NPI:1669128286
Name:MARTINEZ, NATALY VERONICA
Entity type:Individual
Prefix:
First Name:NATALY
Middle Name:VERONICA
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 1:812 BEACH AVE
Mailing Address - Street 2:
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92231-2513
Mailing Address - Country:US
Mailing Address - Phone:619-755-2485
Mailing Address - Fax:
Practice Address - Street 1:812 BEACH AVE
Practice Address - Street 2:
Practice Address - City:CALEXICO
Practice Address - State:CA
Practice Address - Zip Code:92231-2513
Practice Address - Country:US
Practice Address - Phone:619-755-2485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other