Provider Demographics
NPI:1972365229
Name:ZARATE-MARTINEZ, EVELYN (MA, CHW)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:ZARATE-MARTINEZ
Suffix:
Gender:F
Credentials:MA, CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16465 SIERRA LAKES PKWY STE 115
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-1242
Mailing Address - Country:US
Mailing Address - Phone:909-823-8000
Mailing Address - Fax:
Practice Address - Street 1:16465 SIERRA LAKES PKWY STE 115
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-1242
Practice Address - Country:US
Practice Address - Phone:909-823-8000
Practice Address - Fax:909-823-8088
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker