Provider Demographics
NPI:1801491261
Name:MARTINEZ, ASHLEY KUN (AUD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KUN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8254 YOUNGDALE ST
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-1744
Mailing Address - Country:US
Mailing Address - Phone:626-822-0613
Mailing Address - Fax:
Practice Address - Street 1:9439 ARCHIBALD AVE STE 105-106
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7946
Practice Address - Country:US
Practice Address - Phone:321-450-5655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU3488237600000X, 231H00000X
AU3488231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist