Active NPI
Roxanne Harrell Martin, LMFT 46524
- Marriage & Family Therapist
- Fairfield, CA
National Provider Identifier
1235291527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 46524
- Practice address
- 2101 Courage Dr
Solano County Children's Mental Health
Fairfield, CA 94533-6717 - Phone
- (707) 784-4900
- Fax
- (707) 399-4957
- NPI assigned
- Dec 14, 2006
- Last updated
- Feb 28, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 46524 | CA | Primary |
Addresses
Primary practice location
2101 Courage Dr
Solano County Children's Mental Health
Fairfield, CA 94533-6717
Mailing address
PO Box 1058
Suisun City, CA 94585-1058
Phone (707) 784-4900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4383 | Other | CA | MED-I-CAL BILLING NUMBER |
| 2582 | Other | CA | MED-I-CAL BILLING NUMBER |
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 |
|---|---|---|---|
| 46524 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488240000000",
"number": "1235291527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1058",
"city": "SUISUN CITY",
"state": "CA",
"postal_code": "945851058",
"telephone_number": "707-784-4900",
"fax_number": "707-399-4957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 COURAGE DR",
"address_2": "SOLANO COUNTY CHILDREN'S MENTAL HEALTH",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945336717",
"telephone_number": "707-784-4900",
"fax_number": "707-399-4957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ROXANNE",
"middle_name": "HARRELL",
"name_prefix": "Mrs.",
"credential": "LMFT 46524",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2017-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "46524",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MED-I-CAL BILLING NUMBER",
"identifier": "4383",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MED-I-CAL BILLING NUMBER",
"identifier": "2582",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.