Healthcare Provider Details

I. General information

NPI: 1942090113
Provider Name (Legal Business Name): ALISON LYNETTE MARTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 S TAHQUITZ AVE
HEMET CA
92543-5818
US

IV. Provider business mailing address

435 S TAHQUITZ AVE
HEMET CA
92543-5818
US

V. Phone/Fax

Practice location:
  • Phone: 323-799-6876
  • Fax:
Mailing address:
  • Phone: 323-799-6876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: