Brantley-Jackson, Martha Y

Brantley-Jackson, Martha Y is an sole proprietor health care provider with primary practice located at 25400 Alessandro Blvd Ste 101 , Moreno Valley CA 92553-4319. She recently has only one registered license in Managed Care Organizations / Preferred Provider Organization, which is considered as her primary health care specialty. Brantley-Jackson, Martha Y can be contacted via phone (951) 570-0043.

Contact Information

Primary practice address
25400 Alessandro Blvd Ste 101 Moreno Valley CA 92553-4319
Phone: (951) 570-0043
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Preferred Provider Organization 305R00000X California

Profile Details

NPI number 1396302261
LBN Legal business name Brantley-Jackson, Martha Y
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2019
Last updated May 24th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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