Healthcare Provider Details

I. General information

NPI: 1477908663
Provider Name (Legal Business Name): NANCY MARTINEZ-MOLANO PARENT PARTNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2016
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 N. BROADWAY AVENUE
ESCONDIDO CA
92026
US

IV. Provider business mailing address

1029 N. BROADWAY AVENUE
ESCONDIDO CA
92026
US

V. Phone/Fax

Practice location:
  • Phone: 760-489-4126
  • Fax: 760-489-4129
Mailing address:
  • Phone: 760-489-4126
  • Fax: 760-489-4129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: