Healthcare Provider Details

I. General information

NPI: 1407501075
Provider Name (Legal Business Name): CLAUDIA MARTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2022
Last Update Date: 02/12/2022
Certification Date: 02/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 S LOMA LINDA DR
ANAHEIM CA
92804-1718
US

IV. Provider business mailing address

313 S LOMA LINDA DR
ANAHEIM CA
92804-1718
US

V. Phone/Fax

Practice location:
  • Phone: 714-386-2829
  • Fax:
Mailing address:
  • Phone: 714-386-2829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: