Individual provider Active NPI

Jonathan De Jesus Martinez

  • Marriage & Family Therapist
  • Gardena, CA
National Provider Identifier
1356926273
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
148016 Issued in CA
Practice address
740 W 190TH St Ste a
Gardena, CA 90248-4235
Phone
(562) 306-2925
NPI assigned
Mar 11, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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 148016 CA Primary

Addresses

Primary practice location

740 W 190TH St Ste a
Gardena, CA 90248-4235

Mailing address

PO Box 933
South Gate, CA 90280-0933
Phone (323) 671-0633

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
148016CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthews Family Counseling-a Place to Grow Inc CurrentSince Apr 25, 2021 Accepting new patients

Locations

740 W 190th St
Ste A
Gardena, CA 90248
Phone (562) 306-2925

Organizations & group practices 1

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": "1615420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1356926273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902800933",
            "telephone_number": "323-671-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 W 190TH ST STE A",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484235",
            "telephone_number": "562-306-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JONATHAN",
        "middle_name": "DE JESUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-11",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "148016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.