Provider Demographics
NPI:1104801927
Name:MARTINEZMOLES, JOHANNA (MS)
Entity type:Individual
Prefix:MRS
First Name:JOHANNA
Middle Name:
Last Name:MARTINEZMOLES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 RESPONSE RD
Mailing Address - Street 2:KAISER PERMANENTE GENETICS DEPT.
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4807
Mailing Address - Country:US
Mailing Address - Phone:916-614-4784
Mailing Address - Fax:916-614-4768
Practice Address - Street 1:1650 RESPONSE RD
Practice Address - Street 2:KAISER PERMANENTE GENETICS DEPT.
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4807
Practice Address - Country:US
Practice Address - Phone:916-614-4784
Practice Address - Fax:916-614-4768
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS