Jenna Martin, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-29689 Issued in TX

Practice address

2338 W Royal Palm Rd
Phoenix, AZ 85021-9339

Phone

(248) 299-0030

NPI assigned

May 1, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1487142899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2338 W ROYAL PALM RD STE J",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850219339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 W ROYAL PALM RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850219339",
            "telephone_number": "248-299-0030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5700 Rowlett Rd Ste 145",
            "address_purpose": "LOCATION",
            "city": "Rowlett",
            "state": "TX",
            "postal_code": "750897927",
            "country_code": "US",
            "telephone_number": "469-304-1037",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Glencrest Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015145",
            "country_code": "US",
            "telephone_number": "430-625-7905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JENNA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "1-18-29689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB",
            "identifier": "1-18-29689",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary A Martin, PHD
• Giorgio Martin
• Herlynne Martin, OD
• Irene Martin
• Jeffery Merle Martin, M.D.
• Jeri Lynn Martin, O.T.
• Jessica Martin, RN
• Jessica Ann Martin, CRNA
• Jessica Lynn Martin, MSW, MPA
• Johanna Elizabeth Martin

• Behavior Analyst in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.