Provider Demographics
NPI:1982437604
Name:MARTENS, GABRIELLA SUZANNE (RN)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:SUZANNE
Last Name:MARTENS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GABRIELLA
Other - Middle Name:SUZANNE
Other - Last Name:ESTRADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1922 THE ALAMEDA STE 316
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1461
Mailing Address - Country:US
Mailing Address - Phone:082-617-7774
Mailing Address - Fax:408-642-6052
Practice Address - Street 1:652 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2622
Practice Address - Country:US
Practice Address - Phone:650-323-1401
Practice Address - Fax:408-642-6051
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95385814163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse