Healthcare Provider Details

I. General information

NPI: 1750683165
Provider Name (Legal Business Name): ANNA CHRISTINA MARTINEZ N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2010
Last Update Date: 11/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10225 AUSTIN DR SUITE 108
SPRING VALLEY CA
91978-1500
US

IV. Provider business mailing address

10225 AUSTIN DR SUITE 108
SPRING VALLEY CA
91978-1500
US

V. Phone/Fax

Practice location:
  • Phone: 313-909-9495
  • Fax: 619-670-9675
Mailing address:
  • Phone: 313-909-9495
  • Fax: 619-670-9675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND-428
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: