Healthcare Provider Details

I. General information

NPI: 1497681696
Provider Name (Legal Business Name): MARTIN ALFONSO HONORATO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 OAK ST
BAKERSFIELD CA
93304-2433
US

IV. Provider business mailing address

208 OAK ST
BAKERSFIELD CA
93304-2433
US

V. Phone/Fax

Practice location:
  • Phone: 323-426-6402
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: