Active NPI
Martina Glenn, LMFT, LPCC
- Marriage & Family Therapist
- San Jose, CA
National Provider Identifier
1497210462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 124624
- Practice address
- 912 Princess Anne Dr
San Jose, CA 95128-3630 - Phone
- (408) 410-5966
- NPI assigned
- Feb 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 12303 | CA | |
| Marriage & Family Therapist | 106H00000X | 124624 | CA | Primary |
Addresses
Primary practice location
912 Princess Anne Dr
San Jose, CA 95128-3630
Mailing address
912 Princess Anne Dr
San Jose, CA 95128-3630
Phone (408) 410-5966
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 |
|---|---|---|---|
| 124624 | CA | MD | Marriage & Family Therapist |
| 12303 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742688000000",
"number": "1497210462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "912 PRINCESS ANNE DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951283630",
"telephone_number": "408-410-5966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 PRINCESS ANNE DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951283630",
"telephone_number": "408-410-5966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "MARTINA",
"credential": "LMFT, LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-04",
"last_updated": "2025-03-23",
"certification_date": "2025-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "12303",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "124624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.