Individual provider Active NPI

Elaine Martin, RN

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • San Francisco, CA
National Provider Identifier
1104080290
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X
License
RN457587 Issued in CA
Practice address
995 Potrero Avenue
BLDG 80 RM 239
San Francisco, CA 94110-2859
Phone
(415) 206-8386
Fax
(415) 206-6273
NPI assigned
Jul 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X RN457587 CA Primary

Addresses

Primary practice location

995 Potrero Avenue
BLDG 80 RM 239
San Francisco, CA 94110-2859

Mailing address

995 Potrero
BLDG 80 WD 82 RM 239
San Francisco, CA 94110-2859
Phone (415) 206-8386

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN457587CAMDChild & Adolescent Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1104080290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 POTRERO",
            "address_2": "BLDG 80 WD 82 RM 239",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102859",
            "telephone_number": "415-206-8386",
            "fax_number": "415-206-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 POTRERO AVENUE",
            "address_2": "BLDG 80 RM 239",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102859",
            "telephone_number": "415-206-8386",
            "fax_number": "415-206-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CA",
            "license": "RN457587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.