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General NPI Number Information
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NPI Number | 1700405867
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Entity Type | Individual
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Provider Name | JAYLA MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 5400 KEARNY MESA RD
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City | SAN DIEGO
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State | CA
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Zip | 92111-1303
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Country | US
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Telephone | 619-717-2363
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Fax | 619-866-4213
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Provider Business Mailing Address
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Address Line | 2764 RAMBLING VISTA RD
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City | CHULA VISTA
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State | CA
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Zip | 91915
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Country | US
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Telephone | 619-746-5864
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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