Active NPI
Frederick Arthur Martin, PHD
- Psychologist
- Stockton, CA
National Provider Identifier
1184869356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 20746
- Practice address
- 1232 Mill Way
Stockton, CA 95209-4368 - Phone
- (209) 598-9851
- NPI assigned
- Dec 2, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 20746 | CA | Primary |
Addresses
Primary practice location
1232 Mill Way
Stockton, CA 95209-4368
Mailing address
1232 Mill Way
Stockton, CA 95209-4368
Phone (209) 598-9851
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339113600000",
"number": "1184869356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1232 MILL WAY",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952094368",
"telephone_number": "209-598-9851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1232 MILL WAY",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952094368",
"telephone_number": "209-598-9851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "FREDERICK",
"middle_name": "ARTHUR",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-02",
"last_updated": "2012-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "20746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.