Provider Demographics
NPI:1023291275
Name:HERNANDEZ, MARTHA
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 CAYUGA ST
Mailing Address - Street 2:SUITE 11
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2684
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 CAYUGA ST
Practice Address - Street 2:SUITE 11
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2684
Practice Address - Country:US
Practice Address - Phone:831-784-5999
Practice Address - Fax:831-753-1436
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator