Active NPI
Jennifer Martin, PSY.D
- Psychologist
- Newport Beach, CA
National Provider Identifier
1285099317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 27586
- Practice address
- 4299 Macarthur Blvd
Suite 202
Newport Beach, CA 92660-2023 - Phone
- (949) 791-7174
- NPI assigned
- Dec 16, 2015
- Sex
- Female
- 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 | PSY 27586 | CA | Primary |
Addresses
Primary practice location
4299 Macarthur Blvd
Suite 202
Newport Beach, CA 92660-2023
Mailing address
4299 Macarthur Blvd
Suite 202
Newport Beach, CA 92660-2023
Phone (949) 791-7174
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 |
|---|---|---|---|
| PSY 27586 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450224000000",
"number": "1285099317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4299 MACARTHUR BLVD",
"address_2": "SUITE 202",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602023",
"telephone_number": "949-791-7174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4299 MACARTHUR BLVD",
"address_2": "SUITE 202",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602023",
"telephone_number": "949-791-7174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-16",
"last_updated": "2015-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 27586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.