Provider Demographics
NPI:1881692101
Name:MARTINEZ-GUZMAN, JORGE (RN)
Entity type:Individual
Prefix:MR
First Name:JORGE
Middle Name:
Last Name:MARTINEZ-GUZMAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6087 N BUNGALOW LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1519
Mailing Address - Country:US
Mailing Address - Phone:561-373-5228
Mailing Address - Fax:
Practice Address - Street 1:6087 N BUNGALOW LN
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1519
Practice Address - Country:US
Practice Address - Phone:561-373-5228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2728322163WC0200X
CA752752163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience