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NPI Code Detail

MEDICARE: DR. EDINA DAWN MARTINEZ PSY.D.

MEDICARE: DR. EDINA DAWN MARTINEZ PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY20416CA

General Provider Information

NPI Number : 1427190339
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDINA DAWN MARTINEZ PSY.D.
Provider Business Mailing Address
First Line : 1341 N ESCONDIDO BLVD
Second Line :
City : ESCONDIDO
State : CA
Zip : 92026-2507
Country : US
Telephone Number : 760-317-9110
Fax Number :
Provider Business Practice Location Address
First Line : 1341 N ESCONDIDO BLVD
Second Line :
City : ESCONDIDO
State : CA
Zip : 92026-2507
Country : US
Telephone Number : 760-317-9110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2007
Last Update Date : 05/25/2021

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