Provider Demographics
NPI:1992257620
Name:MARTIN, ERIN E
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23823 VALENCIA BLVD
Mailing Address - Street 2:STE 230
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-9513
Mailing Address - Country:US
Mailing Address - Phone:661-254-0172
Mailing Address - Fax:661-254-0017
Practice Address - Street 1:23823 VALENCIA BLVD
Practice Address - Street 2:SUITE # 230
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-9513
Practice Address - Country:US
Practice Address - Phone:661-254-0172
Practice Address - Fax:661-254-0017
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005320363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily