Healthcare Provider Details

I. General information

NPI: 1104745132
Provider Name (Legal Business Name): SILVIA MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5652 VINELAND AVE STE 201
NORTH HOLLYWOOD CA
91601-2062
US

IV. Provider business mailing address

6862 LUBAO AVE
WINNETKA CA
91306-3909
US

V. Phone/Fax

Practice location:
  • Phone: 818-470-6522
  • Fax:
Mailing address:
  • Phone: 818-470-6522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number102257
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: