Active NPI
Priest Martinez
- Addiction (Substance Use Disorder) Counselor
- Lucerne, CA
National Provider Identifier
1043774193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R8725
- Practice address
- 6300 E Hwy 20 Unit B
Lucerne, CA 95458 - Phone
- (707) 274-5610
- Fax
- (707) 600-1325
- NPI assigned
- Jan 23, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R8725 | CA | Primary |
Addresses
Primary practice location
6300 E Hwy 20 Unit B
Lucerne, CA 95458
Mailing address
PO Box 316
Lucerne, CA 95458-0316
Phone (707) 274-5610
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R8725 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548201600000",
"number": "1043774193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 316",
"city": "LUCERNE",
"state": "CA",
"postal_code": "954580316",
"telephone_number": "707-274-5610",
"fax_number": "707-600-1325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6300 E HWY 20 UNIT B",
"city": "LUCERNE",
"state": "CA",
"postal_code": "95458",
"telephone_number": "707-274-5610",
"fax_number": "707-600-1325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "PRIEST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-23",
"last_updated": "2019-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R8725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lucerne, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.