Provider Demographics
NPI:1720284144
Name:CAMP, MARTHA MARZREE (CNA,CHHA)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:MARZREE
Last Name:CAMP
Suffix:
Gender:F
Credentials:CNA,CHHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10948 LINDESMITH AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-3220
Mailing Address - Country:US
Mailing Address - Phone:562-321-5974
Mailing Address - Fax:
Practice Address - Street 1:10948 LINDESMITH AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-3220
Practice Address - Country:US
Practice Address - Phone:562-321-5974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA211642374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered374U00000XNursing Service Related ProvidersHome Health Aide
Not Answered376K00000XNursing Service Related ProvidersNurse's Aide