Active NPI
Ricky Anthony Martin, RRW
- Counselor
- San Jose, CA
National Provider Identifier
1124292024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- RW1183
- Practice address
- 1281 Fleming Ave
San Jose, CA 95127-3610 - Phone
- (408) 259-6565
- NPI assigned
- Apr 22, 2008
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | RW1183 | CA | Primary |
Addresses
Primary practice location
1281 Fleming Ave
San Jose, CA 95127-3610
Mailing address
1281 Fleming Ave
San Jose, CA 95127-3610
Phone (408) 259-6565
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 |
|---|---|---|---|
| RW1183 | CA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208822400000",
"number": "1124292024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1281 FLEMING AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951273610",
"telephone_number": "408-259-6565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1281 FLEMING AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951273610",
"telephone_number": "408-259-6565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "RICKY",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"credential": "RRW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-22",
"last_updated": "2008-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "RW1183",
"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 Apr 22, 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.