Healthcare Provider Details

I. General information

NPI: 1235047200
Provider Name (Legal Business Name): GABRIELLA MARTINEZ OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6264 FERRIS SQ
SAN DIEGO CA
92121-3204
US

IV. Provider business mailing address

1142 CALLE DULCE
CHULA VISTA CA
91910-7021
US

V. Phone/Fax

Practice location:
  • Phone: 619-940-4128
  • Fax:
Mailing address:
  • Phone: 619-616-8098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number29447
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: