Provider Demographics
NPI:1720471030
Name:MARTINEZ, NINA (LHAD)
Entity Type:Individual
Prefix:MRS
First Name:NINA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LHAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 HURLBUT ST APT 12
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3128
Mailing Address - Country:US
Mailing Address - Phone:626-788-7080
Mailing Address - Fax:
Practice Address - Street 1:1268 S LA CIENEGA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2548
Practice Address - Country:US
Practice Address - Phone:310-854-0473
Practice Address - Fax:310-854-5674
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7962237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist