Healthcare Provider Details

I. General information

NPI: 1609730167
Provider Name (Legal Business Name): MARIA ESTHER MARTIZ HERNANDEZ CPT1
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 22ND ST
SAN FRANCISCO CA
94110-2815
US

IV. Provider business mailing address

220 SHADY LN
WALNUT CREEK CA
94597-3330
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-8524
  • Fax: 628-206-4565
Mailing address:
  • Phone: 628-206-8524
  • Fax: 628-206-4565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number94-6000417
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: