Individual provider Active NPI

Martin Molinos

  • Clinical Social Worker
  • Oceanside, CA
National Provider Identifier
1164883138
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105299 Issued in CA
Practice address
1852 Portofino Dr
Oceanside, CA 92054-6130
Phone
(562) 265-8487
NPI assigned
Mar 17, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 76078 CA
Mental Health Counselor 101YM0800X
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 76078 CA
Clinical Social Worker 1041C0700X 105299 CA Primary

Addresses

Primary practice location

1852 Portofino Dr
Oceanside, CA 92054-6130

Mailing address

1852 Portofino Dr
Oceanside, CA 92054-6130
Phone (562) 265-8487

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

LicenseStateTypeSpecialty
105299CAMDClinical Social Worker
76078CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1164883138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1852 PORTOFINO DR",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546130",
            "telephone_number": "562-265-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 PORTOFINO DR",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546130",
            "telephone_number": "562-265-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINOS",
        "first_name": "MARTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-17",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "76078",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "76078",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "105299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.