Healthcare Provider Details

I. General information

NPI: 1992621767
Provider Name (Legal Business Name): GENOA MARLEENA MARTIN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 NATOMA STATION DR STE 300
FOLSOM CA
95630-7968
US

IV. Provider business mailing address

13405 FOLSOM BLVD STE 300
FOLSOM CA
95630-4738
US

V. Phone/Fax

Practice location:
  • Phone: 916-905-6378
  • Fax:
Mailing address:
  • Phone: 916-672-0114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310317
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: