Healthcare Provider Details

I. General information

NPI: 1457483364
Provider Name (Legal Business Name): HALIMAH MARTIN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SYLVIA PATIENCE CNM

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 OLIVE SPRINGS RD
SOQUEL CA
95073-9649
US

IV. Provider business mailing address

602 OLIVE SPRINGS RD
SOQUEL CA
95073-9649
US

V. Phone/Fax

Practice location:
  • Phone: 831-475-2814
  • Fax: 866-593-3489
Mailing address:
  • Phone: 831-475-2814
  • Fax: 866-593-3489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNMW1314
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: