Individual provider Active NPI

Ivonne Berenice Martinez, LCSW

  • Clinical Social Worker
  • Oxnard, CA
National Provider Identifier
1225355498
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW85604 Issued in CA
Practice address
1911 Williams Dr
Suite 110
Oxnard, CA 93036-2612
Phone
(805) 981-4200
Fax
(805) 981-3341
NPI assigned
Apr 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW82623 CA
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X LCSW85604 CA Primary

Addresses

Primary practice location

1911 Williams Dr
Suite 110
Oxnard, CA 93036-2612

Mailing address

1911 Williams Dr
Suite 110
Oxnard, CA 93036-2612
Phone (805) 981-4200

Other practice location 1

7290 El Cajon Blvd
San Diego, CA 92115-1829
Phone (619) 906-5347

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221215002287 CA Practitioner - Clinical Social Worker 5597134460 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW82623CAMDClinical Social Worker
LCSW85604CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego, Inc. CurrentSince Sep 7, 2022 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Sep 7, 2022 Accepting new patients
County of Ventura Past Accepting new patients
County of Ventura PastSince Jun 1, 2023 Accepting new patients
Family Health Centers of San Diego, Inc PastSince May 16, 2021 Accepting new patients

Locations

7290 El Cajon Blvd
San Diego, CA 92115
Phone (619) 255-7705

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 6

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": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1225355498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 WILLIAMS DR",
            "address_2": "SUITE 110",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930362612",
            "telephone_number": "805-981-4200",
            "fax_number": "805-981-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 WILLIAMS DR",
            "address_2": "SUITE 110",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930362612",
            "telephone_number": "805-981-4200",
            "fax_number": "805-981-3341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7290 El Cajon Blvd",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921151829",
            "country_code": "US",
            "telephone_number": "619-906-5347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "IVONNE",
        "middle_name": "BERENICE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-28",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW82623",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW85604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.