Active NPI
Amy Lee Martin, MA
- Marriage & Family Therapist
- San Jose, CA
National Provider Identifier
1114477296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF80632
- Practice address
- 4950 Hamilton Ave Ste 102
San Jose, CA 95130-1748 - Phone
- (408) 507-8931
- Fax
- (408) 350-2015
- NPI assigned
- Oct 12, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF80632 | CA | Primary |
Addresses
Primary practice location
4950 Hamilton Ave Ste 102
San Jose, CA 95130-1748
Mailing address
4950 Hamilton Ave Ste 102
San Jose, CA 95130-1748
Phone (408) 507-8931
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 3, 2024 through Jan 3, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF80632 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Focus Marriage & Family Counseling Inc | Marriage & Family Therapist | 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.
-
- Marriage & Family Therapist
- San Jose, CA
- NPI 1164884706
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476230400000",
"number": "1114477296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4950 HAMILTON AVE STE 102",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951301748",
"telephone_number": "408-507-8931",
"fax_number": "408-350-2015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4950 HAMILTON AVE STE 102",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951301748",
"telephone_number": "408-507-8931",
"fax_number": "408-350-2015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "AMY",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-12",
"last_updated": "2016-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF80632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.