Provider Demographics
NPI:1386443026
Name:MARTINEZ, MARLENE CULATA (NP)
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:CULATA
Last Name:MARTINEZ
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 DE MARCUS BLVD APT 479
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-7532
Mailing Address - Country:US
Mailing Address - Phone:925-999-9222
Mailing Address - Fax:
Practice Address - Street 1:190 S ORCHARD AVE STE B123
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-3650
Practice Address - Country:US
Practice Address - Phone:707-383-4613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031416363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily