Active NPI
Gina Marie Martinez Diaz
- Marriage & Family Therapist
- Rocklin, CA
National Provider Identifier
1164555330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT105043
- Practice address
- 1000 Sunset Blvd Ste 140
Rocklin, CA 95765-5482 - Phone
- (530) 883-0884
- NPI assigned
- Mar 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | LMFT105043 | CA | Primary |
Addresses
Primary practice location
1000 Sunset Blvd Ste 140
Rocklin, CA 95765-5482
Mailing address
11716 Enterprise Drive - Csoc
Auburn, CA 95603
Phone (530) 889-6769
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| LMFT105043 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745366400000",
"number": "1164555330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11716 ENTERPRISE DRIVE - CSOC",
"city": "AUBURN",
"state": "CA",
"postal_code": "95603",
"telephone_number": "530-889-6769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 SUNSET BLVD STE 140",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "957655482",
"telephone_number": "530-883-0884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ DIAZ",
"first_name": "GINA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2025-04-23",
"certification_date": "2025-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT105043",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "N",
"endpointDescription": "Carequuality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "9201 Big Horn Blvd",
"city": "Elk Grove",
"state": "CA",
"country_code": "US",
"postal_code": "957581240",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Rocklin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.