Healthcare Provider Details

I. General information

NPI: 1124386727
Provider Name (Legal Business Name): NANCY ROSEMARY MARTINEZ ORELLANA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NANCY MARTINEZ

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3108 GLENDALE BLVD # 465
LOS ANGELES CA
90039-1806
US

IV. Provider business mailing address

3108 GLENDALE BLVD # 465
LOS ANGELES CA
90039-1806
US

V. Phone/Fax

Practice location:
  • Phone: 213-534-6436
  • Fax:
Mailing address:
  • Phone: 213-534-6436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number129601
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number129601
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: