Healthcare Provider Details

I. General information

NPI: 1982418265
Provider Name (Legal Business Name): DEBORAH MARTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3145 OREGON ST
EUREKA CA
95503-5061
US

IV. Provider business mailing address

2888 LOKER AVE E STE 110
CARLSBAD CA
92010-6683
US

V. Phone/Fax

Practice location:
  • Phone: 888-341-4449
  • Fax:
Mailing address:
  • Phone: 858-401-7633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: