Individual provider Active NPI

Michelle Martinez Tran, LCSW

  • Clinical Social Worker
  • Stockton, CA
National Provider Identifier
1366642068
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
81278 Issued in CA
Practice address
1212 N California St
Stockton, CA 95202-1552
Phone
(209) 468-8686
Fax
(209) 468-2380
NPI assigned
Jul 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 81278 CA Primary
Social Worker 104100000X 28796 CA

Addresses

Primary practice location

1212 N California St
Stockton, CA 95202-1552

Mailing address

1212 N California St
Stockton, CA 95202-1552
Phone (209) 468-8686

Other names 1

  • Michelle Martinez Former name

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
I20240930000253 CA Practitioner - Clinical Social Worker 8123559333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San JoaquinGroup PAC ID 6002703436, 199 clinicians

Practice addresses (Care Compare)

1212 N California St
Stockton, CA 95202-1552
Phone (209) 468-8700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81278CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin Behavioral Health Services Clinical Current Accepting new patients
County of San Joaquin CurrentSince Jun 20, 2024 Accepting new patients
San Joaquin County Behavioral Health Services CurrentSince Jun 20, 2024 Accepting new patients

Locations

1209 W Tokay St
Ste 5
Lodi, CA 95240
Phone (209) 331-2070

1212 N California St
Stockton, CA 95202
Phone (209) 468-8660

Organizations & group practices 3

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": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1366642068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021552",
            "telephone_number": "209-468-8686",
            "fax_number": "209-468-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021552",
            "telephone_number": "209-468-8686",
            "fax_number": "209-468-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "MICHELLE",
        "middle_name": "MARTINEZ",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "81278",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "28796",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MARTINEZ",
            "credential": "ACSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.