Provider Demographics
NPI:1962762245
Name:DIAZ MARTINEZ, CRISTINA (DC)
Entity type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:
Last Name:DIAZ MARTINEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 SEABRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2529
Mailing Address - Country:US
Mailing Address - Phone:408-799-8970
Mailing Address - Fax:831-425-3538
Practice Address - Street 1:1510 SEABRIGHT AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2529
Practice Address - Country:US
Practice Address - Phone:408-799-8970
Practice Address - Fax:831-425-3538
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor