Healthcare Provider Details

I. General information

NPI: 1144574062
Provider Name (Legal Business Name): MARTI L. WILLEY N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2012
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 SANTA FE DR STE 105
ENCINITAS CA
92024-5157
US

IV. Provider business mailing address

FILE 53726
LOS ANGELES CA
90074-0001
US

V. Phone/Fax

Practice location:
  • Phone: 760-452-3340
  • Fax: 760-452-3344
Mailing address:
  • Phone: 800-926-8273
  • Fax: 888-539-8781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number22548
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: