Provider Demographics
NPI:1285884197
Name:MARTZ, THOMAS J (RN)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:MARTZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 TENNYSON RD
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-5417
Mailing Address - Country:US
Mailing Address - Phone:415-517-9916
Mailing Address - Fax:650-692-4331
Practice Address - Street 1:1783 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3205
Practice Address - Country:US
Practice Address - Phone:650-696-5915
Practice Address - Fax:650-692-4331
Is Sole Proprietor?:No
Enumeration Date:2008-09-27
Last Update Date:2008-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550836163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health