Individual provider Active NPI

Debra Cordilia Martinez

  • School Registered Nurse
  • La Puente, CA
National Provider Identifier
1083596860
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
370525 Issued in CA
Practice address
904 Willow Ave
La Puente, CA 91746-1696
Phone
(626) 931-3053
NPI assigned
Jul 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 370525 CA
School Registered Nurse 163WS0200X 370525 CA Primary

Addresses

Primary practice location

904 Willow Ave
La Puente, CA 91746-1696

Mailing address

904 Willow Ave
La Puente, CA 91746-1696
Phone (626) 931-3053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
370525CAMDSchool Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1083596860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 WILLOW AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917461696",
            "telephone_number": "626-931-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 WILLOW AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917461696",
            "telephone_number": "626-931-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "DEBRA",
        "middle_name": "CORDILIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "370525",
            "primary": false
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "CA",
            "license": "370525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Puente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.