Provider Demographics
NPI:1669922365
Name:MARTINEZ, NATALIE BIRALDE (DPT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:BIRALDE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4610
Mailing Address - Country:US
Mailing Address - Phone:650-580-4492
Mailing Address - Fax:
Practice Address - Street 1:1489 WEBSTER ST
Practice Address - Street 2:SUITE #210
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3766
Practice Address - Country:US
Practice Address - Phone:415-346-8373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT291638225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist