Provider Demographics
NPI:1548664022
Name:MARTINEZ, CRISTIAN (FNP)
Entity type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CRISTIAN
Other - Middle Name:
Other - Last Name:VARGAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:51544 CESAR CHAVEZ ST
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-1501
Mailing Address - Country:US
Mailing Address - Phone:760-861-1436
Mailing Address - Fax:
Practice Address - Street 1:51544 CESAR CHAVEZ ST STE 1D
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-1504
Practice Address - Country:US
Practice Address - Phone:760-861-1436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2025-05-16
Deactivation Date:2016-11-23
Deactivation Code:
Reactivation Date:2025-01-09
Provider Licenses
StateLicense IDTaxonomies
CA95035083363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily