Individual provider Active NPI

Etta Louise Martin, LCSW

  • Clinical Social Worker
  • Sherman Oaks, CA
National Provider Identifier
1487639852
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS21526 Issued in CA
Practice address
4911 Van Nuys Blvd
Suite 102
Sherman Oaks, CA 91403-1716
Phone
(818) 817-3248
Fax
(818) 905-2845
NPI assigned
Dec 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS21526 CA Primary

Addresses

Primary practice location

4911 Van Nuys Blvd
Suite 102
Sherman Oaks, CA 91403-1716

Mailing address

4201 Ventura Canyon Ave
Sherman Oaks, CA 91423-4329
Phone (818) 789-8784

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS21526CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1487639852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 VENTURA CANYON AVE",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914234329",
            "telephone_number": "818-789-8784",
            "fax_number": "818-905-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 VAN NUYS BLVD",
            "address_2": "SUITE 102",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031716",
            "telephone_number": "818-817-3248",
            "fax_number": "818-905-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ETTA",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS21526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.