Individual provider Active NPI

Dena Martinez, FNP

  • Women's Health Nurse Practitioner
  • San Bernardino, CA
National Provider Identifier
1760203038
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
95031884 Issued in CA
Practice address
855 E Hospitality LN
San Bernardino, CA 92408-3596
Phone
(909) 885-0282
NPI assigned
Oct 21, 2024
Last updated
Mar 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95031884 CA
Women's Health Nurse Practitioner 363LW0102X 95031884 CA Primary

Addresses

Primary practice location

855 E Hospitality LN
San Bernardino, CA 92408-3596

Mailing address

855 E Hospitality LN
San Bernardino, CA 92408-3596
Phone (909) 885-0282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250409001553 CA Practitioner - Nurse Practitioner 3971027152 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Healthcare of California CurrentSince Apr 7, 2025 Accepting new patients
Central Health Plan of California, Inc. CurrentSince Apr 7, 2025 Accepting new patients
Family Planning Associates Medical Group Inc CurrentSince Oct 27, 2024 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

855 E Hospitality Ln
San Bernardino, CA 92408
Phone (909) 855-0282

Interoperability endpoints

  • Direct secure messaging: dena.martinez.p1@direct.fpawomenshealth.nextgenshare.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1760203038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 E HOSPITALITY LN",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083596",
            "telephone_number": "909-885-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 E HOSPITALITY LN",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083596",
            "telephone_number": "909-885-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "DENA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95031884",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "95031884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.