Axa Elizabeth Orellana Martinez

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

MPSS-WIXMEH Issued in CA

Practice address

308 E San Jacinto Ave
Perris, CA 92570-2878

Phone

(951) 600-6382

NPI assigned

Dec 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1962115402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 E SAN JACINTO AVE",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925702878",
            "telephone_number": "951-600-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E SAN JACINTO AVE",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925702878",
            "telephone_number": "951-600-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORELLANA MARTINEZ",
        "first_name": "AXA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-29",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-WIXMEH",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Peer Specialist in Perris, CA
• Providers in Perris, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.