Individual provider Active NPI

Elena F Martinez, MA CCC SLP

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1013246339
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 14517 Issued in CA
Practice address
15347 Maturin Dr
Unit 106
San Diego, CA 92127-2302
Phone
(307) 760-9342
NPI assigned
Dec 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP 14517 CA Primary

Addresses

Primary practice location

15347 Maturin Dr
Unit 106
San Diego, CA 92127-2302

Mailing address

4357 Cleveland Ave
Unit 103
San Diego, CA 92103-2495
Phone (307) 760-9342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP 14517CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Wyoming Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1013246339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4357 CLEVELAND AVE",
            "address_2": "UNIT 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032495",
            "telephone_number": "307-760-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15347 MATURIN DR",
            "address_2": "UNIT 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921272302",
            "telephone_number": "307-760-9342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ELENA",
        "middle_name": "F",
        "credential": "MA CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 14517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.