Provider Demographics
NPI:1720892045
Name:TRUEBA, LETICIA MARTINEZ (SOLE PROPRI)
Entity type:Individual
Prefix:
First Name:LETICIA
Middle Name:MARTINEZ
Last Name:TRUEBA
Suffix:
Gender:F
Credentials:SOLE PROPRI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2392 HIGHVIEW LN
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-3622
Mailing Address - Country:US
Mailing Address - Phone:619-240-1044
Mailing Address - Fax:
Practice Address - Street 1:2392 HIGHVIEW LN
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-3622
Practice Address - Country:US
Practice Address - Phone:619-240-1044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider