Provider Demographics
NPI:1669276275
Name:MARTINEZ, CARIDAD RIANE
Entity type:Individual
Prefix:
First Name:CARIDAD
Middle Name:RIANE
Last Name:MARTINEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82704 MILES AVE
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-4230
Mailing Address - Country:US
Mailing Address - Phone:760-342-5727
Mailing Address - Fax:760-342-5674
Practice Address - Street 1:82704 MILES AVE
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-4230
Practice Address - Country:US
Practice Address - Phone:760-342-5727
Practice Address - Fax:760-342-5674
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMPSS-QWFTLR175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist