Basic Information
| Provider Information | |||||||||
| NPI: | 1952739906 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARTINEZ | ||||||||
| FirstName: | ERIKA | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | |||||||||
| Credential: | SPA 2102 | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | INZUNZA | ||||||||
| OtherFirstName: | ERIKA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 14030 MCCLURE AVE | ||||||||
| Address2: | 109 | ||||||||
| City: | PARAMOUNT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907232273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626592164 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 12411 SLAUSON AVE | ||||||||
| Address2: | UNIT H | ||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906062835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626935449 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2013 | ||||||||
| LastUpdateDate: | 11/12/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2355S0801X | SPA 2102 | CA | Y | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant |
No ID Information.