Individual provider Active NPI

Georgina Martinez, CCC-SLP

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1336497668
Registry record updated Aug 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 19764 Issued in CA
Practice address
8775 Aero Dr
San Diego, CA 92123-1792
Phone
(858) 571-0030
NPI assigned
Aug 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP 19764 CA Primary

Addresses

Primary practice location

8775 Aero Dr
San Diego, CA 92123-1792

Mailing address

1194 Camino Biscay
Chula Vista, CA 91910-7700
Phone (619) 370-4476

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

LicenseStateTypeSpecialty
SP 19764CAMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345075200000",
    "number": "1336497668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1194 CAMINO BISCAY",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107700",
            "telephone_number": "619-370-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8775 AERO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231792",
            "telephone_number": "858-571-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "GEORGINA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-16",
        "last_updated": "2012-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 19764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.