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NPI Code Detail

MEDICARE: KRISTINE ELIZABETH MARTINEZ

MEDICARE: KRISTINE ELIZABETH MARTINEZ
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
1101YM0800XMental Health Counselor
2171M00000XCase Manager/Care Coordinator
3225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1336479229
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINE ELIZABETH MARTINEZ
Provider Business Mailing Address
First Line : 341 IRWIN LN
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-5603
Country : US
Telephone Number : 707-360-1511
Fax Number :
Provider Business Practice Location Address
First Line : 341 IRWIN LN
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-5603
Country : US
Telephone Number : 707-360-1511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2009
Last Update Date : 02/09/2026

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Directions to “ KRISTINE ELIZABETH MARTINEZ ” Practice Location

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