Juana M. Martin

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95020370 Issued in CA

Practice address

602 W 6TH St
Corona, CA 92882-3209

Phone

(951) 256-2783

NPI assigned

Aug 29, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clinica Medica Mi Pueblo, Medical Clinic, Inc

  • Primary Care Clinic/Center
  • Corona, CA
  • NPI 1144571985
  NPD (past)

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1285354571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 W 6TH ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823209",
            "telephone_number": "951-534-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W 6TH ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823209",
            "telephone_number": "951-256-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JUANA",
        "middle_name": "M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://clinicamipueblo.com/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "602 W 6th St",
            "city": "Corona",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928823209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Raymond Martez, M.S.
• Adrianna Martin, OTR/L
• Alexus Martin
• Deborah Annmarie Martin, PHARMD
• Jenna Martin
• Wendy S Martin, MD
• Martinez and Zermeno III Apdc
• Alec Martinez
• Angel Martinez
• Anthony Ray Martinez

• Family Nurse Practitioner in Corona, CA
• Providers in Corona, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.