Provider Demographics
NPI:1528859170
Name:MARTINEZ, JOLEEN KRISTINE I
Entity type:Individual
Prefix:
First Name:JOLEEN
Middle Name:KRISTINE
Last Name:MARTINEZ
Suffix:I
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 1:912 CALLE QUINTANA
Mailing Address - Street 2:
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-3051
Mailing Address - Country:US
Mailing Address - Phone:505-901-7010
Mailing Address - Fax:
Practice Address - Street 1:912 CALLE QUINTANA
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-3051
Practice Address - Country:US
Practice Address - Phone:505-901-7010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator