Active NPI
Jennifer Sue Martinez, PH.D.
- Clinical Psychologist
- Salem, UT
National Provider Identifier
1275845596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 7718070-2501
- Practice address
- 170 E 300 S
Salem, UT 84653-9453 - Phone
- (801) 616-2825
- NPI assigned
- Jul 2, 2010
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 7718070-2501 | UT | Primary |
Addresses
Primary practice location
170 E 300 S
Salem, UT 84653-9453
Mailing address
PO Box 728
Spanish Fork, UT 84660-0728
Phone (801) 616-2825
Other practice location 1
237 NE Chkalov Dr
Vancouver, WA 98684-5054
Phone (801) 616-2825
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7718070-2501 | UT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544486400000",
"number": "1275845596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 728",
"city": "SPANISH FORK",
"state": "UT",
"postal_code": "846600728",
"telephone_number": "801-616-2825",
"fax_number": "510-380-3195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 E 300 S",
"city": "SALEM",
"state": "UT",
"postal_code": "846539453",
"telephone_number": "801-616-2825"
}
],
"practiceLocations": [
{
"address_1": "237 NE Chkalov Dr",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "986845054",
"country_code": "US",
"telephone_number": "801-616-2825",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTINEZ",
"first_name": "JENNIFER",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-02",
"last_updated": "2018-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "7718070-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.