MEDICARE: VANESSA NICHOLE 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
1	171M00000X	Case Manager/Care Coordinator
2	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1942653647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA NICHOLE MARTINEZ

Provider Business Mailing Address
First Line	:	3545 LONG BEACH BLVD
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3941
Country	:	US
Telephone Number	:	562-490-7600
Fax Number	:	562-490-7601

Provider Business Practice Location Address
First Line	:	3545 LONG BEACH BLVD
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3941
Country	:	US
Telephone Number	:	562-490-7600
Fax Number	:	562-490-7601

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

Provider Enumeration Date	:	07/18/2016
Last Update Date	:	01/12/2026

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Directions to “ VANESSA NICHOLE MARTINEZ ” Practice Location

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