Provider Demographics
NPI:1447822580
Name:MARTINEZ-JOHNSON, JOCELYN MELISSA (RN)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:MELISSA
Last Name:MARTINEZ-JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5623 PLAZA CT
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-4692
Mailing Address - Country:US
Mailing Address - Phone:310-806-2140
Mailing Address - Fax:
Practice Address - Street 1:5623 PLAZA CT
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552-4692
Practice Address - Country:US
Practice Address - Phone:310-806-2140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA721405163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Single Specialty