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General NPI Number Information
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NPI Number | 1821981382
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Entity Type | Individual
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Provider Name | BRIANA NADINE MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 1050 PACIFIC COAST HWY
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City | HARBOR CITY
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State | CA
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Zip | 90710-3500
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Country | US
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Telephone | 833-574-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 137 N 20TH ST
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City | MONTEBELLO
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State | CA
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Zip | 90640-4040
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Country | US
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Telephone | 323-804-4991
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | AUD-RPE-000298
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License Number State | CA
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