Individual
COELISE H MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
390 40TH ST, OAKLAND, CA 94609-2633
(510) 613-0330
(510) 569-4589
Mailing address
390 40TH ST, OAKLAND, CA 94609-2633
(510) 613-0330
(510) 569-4589
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
N9378568
CA
Other
Enumeration date
10/31/2019
Last updated
10/31/2019
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