Provider Demographics
NPI:1548959042
Name:MARTIN, JOSHUA DEAN (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DEAN
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17663 HIGH BLUFF CT
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-7761
Mailing Address - Country:US
Mailing Address - Phone:714-944-2133
Mailing Address - Fax:
Practice Address - Street 1:921 PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-6244
Practice Address - Country:US
Practice Address - Phone:562-598-0473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95023877363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily