Healthcare Provider Details

I. General information

NPI: 1023182425
Provider Name (Legal Business Name): DENISE L. MARTIN-SAHIM AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 PENNSYLVANIA AVE STE B
FAIRFIELD CA
94533-3510
US

IV. Provider business mailing address

1700 PENNSYLVANIA AVE STE B
FAIRFIELD CA
94533-3510
US

V. Phone/Fax

Practice location:
  • Phone: 707-426-4327
  • Fax: 707-426-5190
Mailing address:
  • Phone: 707-426-4327
  • Fax: 707-426-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number680233061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: