Individual provider Active NPI

Martha Lucia Esquivel, PSYD

  • Clinical Psychologist
  • Chino, CA
National Provider Identifier
1306162235
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY24155 Issued in CA
Practice address
14901 Central Ave
Chino, CA 91710-9500
Phone
(909) 597-1821
NPI assigned
Apr 16, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY24155 CA Primary

Addresses

Primary practice location

14901 Central Ave
Chino, CA 91710-9500

Mailing address

PO Box 108
Azusa, CA 91702-0108
Phone (909) 245-6794

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
I20210611001638 CA Practitioner - Clinical Psychologist 2264832211 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY24155CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Soultenders, Inc. Clinical CurrentSince Mar 4, 2021 Accepting new patients
Soultenders Psychological Services, Inc. CurrentSince Jul 1, 2026 Accepting new patients
Corrections and Rehabilitation-Headquarters PastSince Mar 22, 2020 Accepting new patients
North Kern State Prison Past Accepting new patients

Locations

41 E Foothill Blvd
Ste 102
Arcadia, CA 91006
Phone (626) 701-4249

250 W 1st St
Ste 346
Claremont, CA 91711
Phone (909) 343-4550

Organizations & group practices 4

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": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1306162235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917020108",
            "telephone_number": "909-245-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14901 CENTRAL AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917109500",
            "telephone_number": "909-597-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESQUIVEL",
        "first_name": "MARTHA",
        "middle_name": "LUCIA",
        "name_prefix": "Miss",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-16",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY24155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.