Individual provider Active NPI

Dianne Haines Martin

  • Marriage & Family Therapist
  • La Crescenta, CA
National Provider Identifier
1356121339
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT128716 Issued in CA
Practice address
1 Mountain Oaks Park
La Crescenta, CA 91214-3346
Phone
(818) 425-2612
NPI assigned
Oct 5, 2023
Last updated
Oct 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT128716 CA Primary

Addresses

Primary practice location

1 Mountain Oaks Park
La Crescenta, CA 91214-3346

Mailing address

1 Mountain Oaks Park
La Crescenta, CA 91214-3346
Phone (818) 425-2612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT128716CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1356121339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MOUNTAIN OAKS PARK",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143346",
            "telephone_number": "818-425-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MOUNTAIN OAKS PARK",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143346",
            "telephone_number": "818-425-2612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DIANNE",
        "middle_name": "HAINES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT128716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crescenta, CA

Sources for this page

Verify at the official NPI Registry.