Active NPI
Ivonne Diaz Martinez, BA
- Mental Health Counselor
- Richmond, CA
National Provider Identifier
1497332365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 205 39TH St
Richmond, CA 94805-2212 - Phone
- (510) 412-5930
- Fax
- (510) 412-0567
- NPI assigned
- Mar 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
205 39TH St
Richmond, CA 94805-2212
Mailing address
1810 Chanslor Ave
Richmond, CA 94801-3646
Phone (415) 573-5908
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
- Credentials
- Bachelor of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Desarrollo Familiar, Inc | Mental Health | Current | Accepting new patients |
| Desarrollo Familiar | Past | Accepting new patients |
Locations
205 39th St
Richmond, CA 94805
Phone (510) 412-5930
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Richmond, CA
- NPI 1376692459
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620000000000",
"number": "1497332365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1810 CHANSLOR AVE",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948013646",
"telephone_number": "415-573-5908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 39TH ST",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948052212",
"telephone_number": "510-412-5930",
"fax_number": "510-412-0567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ MARTINEZ",
"first_name": "IVONNE",
"credential": "BA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-26",
"last_updated": "2021-05-03",
"certification_date": "2021-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.