Healthcare Provider Details

I. General information

NPI: 1245051325
Provider Name (Legal Business Name): K'LEI LOURDES MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 CAMINO DEL REMEDIO
SANTA BARBARA CA
93110-1332
US

IV. Provider business mailing address

18 ARROYO VISTA DR
GOLETA CA
93117-1071
US

V. Phone/Fax

Practice location:
  • Phone: 805-465-8199
  • Fax:
Mailing address:
  • Phone: 805-570-1058
  • Fax:

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: