Healthcare Provider Details

I. General information

NPI: 1003565185
Provider Name (Legal Business Name): SELINA MARIE MARTINEZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 09/01/2025
Certification Date: 09/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3285 CLAREMONT WAY
NAPA CA
94558-3313
US

IV. Provider business mailing address

3285 CLAREMONT WAY
NAPA CA
94558-3300
US

V. Phone/Fax

Practice location:
  • Phone: 707-258-2500
  • Fax:
Mailing address:
  • Phone: 707-258-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR0072968
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A24057
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: