Healthcare Provider Details

I. General information

NPI: 1730710575
Provider Name (Legal Business Name): KORINNA MARTINS CNM, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KORINNA DE LA ROSA

II. Dates (important events)

Enumeration Date: 01/30/2020
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 W WILLOW AVE STE 502
VISALIA CA
93291-6268
US

IV. Provider business mailing address

202 W WILLOW AVE STE 502
VISALIA CA
93291-6268
US

V. Phone/Fax

Practice location:
  • Phone: 559-624-4820
  • Fax: 559-624-6590
Mailing address:
  • Phone: 559-624-4820
  • Fax: 559-624-6590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95014287
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number236099
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: