MEDICARE: MRS. ALEJANDRINA MARTIN BSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1215023049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALEJANDRINA MARTIN BSW

Provider Business Mailing Address
First Line	:	4530 MIAMI WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4530 MIAMI WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117
Country	:	US
Telephone Number	:	858-581-3273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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