Ernesto Martinez
Individual provider Active NPI Occupational Therapist · Walnut Park, CA
NPI 1265725451 · NPPES record last updated Jun 14, 2024
Key facts
- NPI
- 1265725451
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT4089 (CA)
- Practice address
- 3019 Grand Ave
Walnut Park, CA 90255-6228 - Phone
- (323) 583-6691
- NPI assigned
- May 19, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240930003622 | CA | Practitioner - Occupational Therapist in Private Practice | 1951832047 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT4089 | CA | MD | Occupational Therapist |
| OTL15232 | MA | MD | Occupational Therapist |
| 1052095 | OR | MD | Occupational Therapist |
| OC019971 | PA | MD | Occupational Therapist |
| OT.61520661 | WA | MD | Occupational Therapist |
| 4089 | CA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Care to You Health | Multi-Specialty | Current |
Accepting new patients |
Locations
2102 Business Center Dr
Irvine, CA 92612
Phone (562) 541-8950
2570 N 1st St
Fl 2
San Jose, CA 95131
Phone (408) 404-4900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT.61520661 | WA | |
| Occupational Therapist |
225X00000X | OC019971 | PA | |
| Occupational Therapist |
225X00000X | 1052095 | OR | |
| Occupational Therapist |
225X00000X | OTL15232 | MA | |
| Occupational Therapist |
225X00000X | OT4089 | CA | Yes |
Addresses
Primary practice location
3019 Grand Ave
Walnut Park, CA 90255-6228
Mailing address
3019 Grand Ave
Walnut Park, CA 90255-6228
Other providers in Walnut Park, CA
- Anaiz Loaiza
- Rene Alexander Lopez Sr.
- Los Reyes Clinica Medica Urgencias Inc.
- Lynwood Medical Imaging LLC
- Hira Maalik
- Jorge Martinez
- Paula Martinez I
- Williams Roland Martinez
- Ashley Mendoza
- Selena Mercado
All providers in Walnut Park, CA · Occupational Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.