Individual provider Active NPI

Elysha Martinez, LMFT

  • Marriage & Family Therapist
  • Oakland, CA
National Provider Identifier
1164950044
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
93493 Issued in CA
Practice address
166 Santa Clara Ave Ste 202
Oakland, CA 94610-1323
Phone
(510) 463-4123
NPI assigned
May 23, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 93493 CA Primary

Addresses

Primary practice location

166 Santa Clara Ave Ste 202
Oakland, CA 94610-1323

Mailing address

166 Santa Clara Ave Ste 202
Oakland, CA 94610-1323
Phone (510) 463-4123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 19, 2024 through Aug 19, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
93493CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Axis Mundi Center for Mental Health PastSince May 22, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164950044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 SANTA CLARA AVE STE 202",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101323",
            "telephone_number": "510-463-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 SANTA CLARA AVE STE 202",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101323",
            "telephone_number": "510-463-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ELYSHA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "93493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.