Healthcare Provider Details

I. General information

NPI: 1073943007
Provider Name (Legal Business Name): PEARL MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2013
Last Update Date: 11/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W GABILAN ST
SALINAS CA
93901-2762
US

IV. Provider business mailing address

130 W GABILAN ST
SALINAS CA
93901-2762
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-8155
  • Fax: 831-422-9411
Mailing address:
  • Phone: 831-755-8155
  • Fax: 831-422-9411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: