Individual
ELOISA SEVILLA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15305 RAYEN ST, NORTH HILLS, CA 91343-5117
(818) 892-3423
Mailing address
13052 OSBORNE ST, PACOIMA, CA 91331-4030
(818) 492-0165
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDICAL
CA
Enumeration date
03/09/2022
Last updated
09/25/2023
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