Provider Demographics
NPI:1780600585
Name:MARTINEZ, MARCEE ANNE (PT)
Entity type:Individual
Prefix:
First Name:MARCEE
Middle Name:ANNE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARCEE
Other - Middle Name:ANNE
Other - Last Name:SAVAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 493396
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-3396
Mailing Address - Country:US
Mailing Address - Phone:530-221-9952
Mailing Address - Fax:530-221-9910
Practice Address - Street 1:1225 EUREKA WAY
Practice Address - Street 2:SUITE B
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0815
Practice Address - Country:US
Practice Address - Phone:530-221-9952
Practice Address - Fax:530-221-9910
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT21555225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ24040ZOtherMEDICARE GROUP
CA0PT215551Medicare ID - Type Unspecified
0PT215551Medicare PIN