Individual provider Active NPI

Mary Martinell Henze

  • Speech-Language Pathologist
  • San Diego, CA
National Provider Identifier
1508371048
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1790 Issued in CA
Practice address
4204A Adams Ave
San Diego, CA 92116-2300
Phone
(866) 353-7829
NPI assigned
Dec 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1790 CA Primary

Addresses

Primary practice location

4204A Adams Ave
San Diego, CA 92116-2300

Mailing address

4204A Adams Ave
San Diego, CA 92116-2300
Phone (866) 353-7829

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

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1508371048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204A ADAMS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921162300",
            "telephone_number": "866-353-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4204A ADAMS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921162300",
            "telephone_number": "866-353-7829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENZE",
        "first_name": "MARY",
        "middle_name": "MARTINELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "1790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; 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.