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Individual

JOHANNA IVELISSE MARTINEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
555 N PERRIS BLVD BLDG A, PERRIS, CA 92571-2811
(951) 436-5300
Mailing address
2085 RUSTIN AVE STE 1, RIVERSIDE, CA 92507-2498
(951) 955-7320

Taxonomy

Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary

Other

Enumeration date
12/22/2022
Last updated
06/17/2025
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