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General NPI Number Information
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NPI Number | 1083491179
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Entity Type | Individual
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Provider Name | BIANCA YERALDIN MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 3301 37TH AVE
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City | SACRAMENTO
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State | CA
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Zip | 95824-2418
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Country | US
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Telephone | 191-621-0877
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Fax |
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Provider Business Mailing Address
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Address Line | 3130 COTTAGE PARK AVE
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City | SACRAMENTO
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State | CA
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Zip | 95825-2113
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Country | US
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Telephone | 916-678-8507
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | CA
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