Individual
DEIRDRE ANN MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1179 N MCDOWELL BLVD, PETALUMA, CA 94954-6559
(707) 559-7500
Mailing address
66 OXFORD DR, SAN RAFAEL, CA 94903-2887
(415) 246-5409
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2025223
CA
363LF0000X
Family Nurse Practitioner
Primary
95022828
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/17/2020
Last updated
02/09/2023
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