Basic Information
| Provider Information | |||||||||
| NPI: | 1437331840 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARTINS | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN, BSN, PHN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 355 | ||||||||
| Address2: | BLDG 11 | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145621746 | ||||||||
| FaxNumber: | 7145621773 | ||||||||
| Practice Location | |||||||||
| Address1: | 1725 WEST 17TH STREET | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148347763 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2007 | ||||||||
| LastUpdateDate: | 11/28/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC1500X | 674648 | CA | Y | Nursing Service Providers | Registered Nurse | Community Health |
No ID Information.