Active NPI
Jessica Martinez
- Mental Health Counselor
- Anaheim, CA
National Provider Identifier
1407345309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 106110
- Practice address
- 4882 E Gayann Dr
Anaheim, CA 92807-3005 - Phone
- (714) 624-8018
- NPI assigned
- May 7, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 106110 | CA | Primary |
Addresses
Primary practice location
4882 E Gayann Dr
Anaheim, CA 92807-3005
Mailing address
1968 S Coast Hwy Ste 4651
Laguna Beach, CA 92651-3681
Phone (714) 758-5809
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240709004101 | CA | Practitioner - Marriage and Family Therapist | 6305389156 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psistema Inc. | Mental Health | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Anaheim, CA
- NPI 1851763098
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760313600000",
"number": "1407345309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1968 S COAST HWY STE 4651",
"city": "LAGUNA BEACH",
"state": "CA",
"postal_code": "926513681",
"telephone_number": "714-758-5809",
"fax_number": "714-784-2424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4882 E GAYANN DR",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928073005",
"telephone_number": "714-624-8018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-07",
"last_updated": "2025-10-13",
"certification_date": "2025-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "106110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.