Provider Demographics
NPI:1912468786
Name:MARTINEZ, MARILYN C
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:C
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-5319
Mailing Address - Country:US
Mailing Address - Phone:408-225-4276
Mailing Address - Fax:
Practice Address - Street 1:540 N 1ST ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-5319
Practice Address - Country:US
Practice Address - Phone:408-401-4694
Practice Address - Fax:408-510-3426
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No171M00000XOther Service ProvidersCase Manager/Care Coordinator