Provider Information for 1508344714
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
PATRICIA MARRAINE MARTIN LMFT
Sex: Female
NPI: 1508344714
Last Updated: 2021-02-26
Certification Date: 2021-02-26
Certification Date: 2021-02-26
Details
Name | Value | ||||||||
---|---|---|---|---|---|---|---|---|---|
NPI | 1508344714 | ||||||||
Enumeration Date | 2018-07-31 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | PO BOX 1054 MIRA LOMA, CA 91752-8054 United States Phone: 951-893-8129 | Fax: | ||||||||
Primary Practice Address | 1625 14TH ST RIVERSIDE, CA 92503 United States Phone: 951-955-1560 | Fax: | ||||||||
Secondary Practice Address(es) | |||||||||
Health Information Exchange |
| ||||||||
Other Identifiers |
| ||||||||
Taxonomy |
|