Active NPI
Sandra Yvette Martinez, PSYCHOLOGIST
- Psychologist
- Los Angeles, CA
National Provider Identifier
1427328962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY31694
- Practice address
- 600 S Commonwealth Ave
Los Angeles, CA 90005-4001 - Phone
- (213) 739-5552
- NPI assigned
- Dec 30, 2011
- Reactivated
- Jun 19, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PSY31694 | CA | |
| Forensic Psychologist | 103TF0200X | PSY31694 | CA | |
| Psychologist | 103T00000X | PSY31694 | CA | Primary |
Addresses
Primary practice location
600 S Commonwealth Ave
Los Angeles, CA 90005-4001
Mailing address
PO Box 1224
South Pasadena, CA 91031-1224
Phone (323) 921-2494
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY31694 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institutes of Health Behavioral Medicine and Medical Psychology Inc. | 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.
-
- Clinical Psychologist
- Oceanside, CA
- NPI 1407392319
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592956800000",
"number": "1427328962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1224",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910311224",
"telephone_number": "323-921-2494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 S COMMONWEALTH AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900054001",
"telephone_number": "213-739-5552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "SANDRA",
"middle_name": "YVETTE",
"name_prefix": "Dr.",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-30",
"last_updated": "2020-06-24",
"certification_date": "2020-06-24",
"deactivation_date": "2016-01-20",
"reactivation_date": "2020-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "PSY31694",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "CA",
"license": "PSY31694",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY31694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.