Healthcare Provider Details

I. General information

NPI: 1821981382
Provider Name (Legal Business Name): BRIANA NADINE MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CONGRESS ST STE 103
PASADENA CA
91105-3027
US

IV. Provider business mailing address

137 N 20TH ST
MONTEBELLO CA
90640-4040
US

V. Phone/Fax

Practice location:
  • Phone: 626-796-7194
  • Fax: 626-796-0883
Mailing address:
  • Phone: 323-804-4991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU-4194
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: