Provider Demographics
NPI:1164230397
Name:MARTINEZ, DANIELLE DIDONATO
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:DIDONATO
Last Name:MARTINEZ
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 1:24705 RIVERCHASE DR APT 6205
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1424
Mailing Address - Country:US
Mailing Address - Phone:310-709-4588
Mailing Address - Fax:
Practice Address - Street 1:24705 RIVERCHASE DR APT 6205
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1424
Practice Address - Country:US
Practice Address - Phone:310-709-4588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19954174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator