Healthcare Provider Details

I. General information

NPI: 1790455608
Provider Name (Legal Business Name): ESTHER D MARTINEZ CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

581 61ST ST
OAKLAND CA
94609-1248
US

IV. Provider business mailing address

1011 UNION ST STE 912
OAKLAND CA
94607-2236
US

V. Phone/Fax

Practice location:
  • Phone: 510-654-7787
  • Fax:
Mailing address:
  • Phone: 510-879-2538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14335813
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: