Maria R. Martin, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY27160 Issued in CA

Practice address

100 W Foothill Blvd Ste 104
San Dimas, CA 91773-1170

Phone

(909) 519-2662

Fax

(909) 575-4528

NPI assigned

Feb 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1487796074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W FOOTHILL BLVD STE 104",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731170",
            "telephone_number": "909-519-2662",
            "fax_number": "909-575-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W FOOTHILL BLVD STE 104",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731170",
            "telephone_number": "909-519-2662",
            "fax_number": "909-575-4528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 S Jackson St Ste 204",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912054918",
            "country_code": "US",
            "telephone_number": "909-519-2662",
            "fax_number": "909-575-4528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MARIA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 36100",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Carlos Marquez
• Miguel Marquez
• Savana Kate Marroquin
• Amanda Martin
• Jacqueline Martin
• Ashley Nicole Martinez
• Faith Martinez
• Jennifer Marie Martinez
• Marisol Martinez
• Melanie Martinez

• Clinical Psychologist in San Dimas, CA
• Providers in San Dimas, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.