Individual provider Active NPI

Martha Jane Joachim, PH.D.

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1447449558
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY7032 Issued in CA
Practice address
12549 Woodbine St
Los Angeles, CA 90066-1830
Phone
(310) 477-0769
Fax
(310) 390-9927
NPI assigned
Oct 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY7032 CA Primary

Addresses

Primary practice location

12549 Woodbine St
Los Angeles, CA 90066-1830

Mailing address

12549 Woodbine St
Los Angeles, CA 90066-1830
Phone (310) 477-0769

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
I20101122000688 CA Practitioner - Clinical Psychologist 2062608656 Practice locations: Healdsburg, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1795 Boxheart Dr
Unit 131
Healdsburg, CA 95448-6402
Phone (310) 390-9927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY7032CAMDPsychologist
7032CAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1447449558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12549 WOODBINE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900661830",
            "telephone_number": "310-477-0769",
            "fax_number": "310-390-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12549 WOODBINE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900661830",
            "telephone_number": "310-477-0769",
            "fax_number": "310-390-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOACHIM",
        "first_name": "MARTHA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY7032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.