Individual provider Active NPI

Jeannette Elizabeth Martello

  • Addiction (Substance Use Disorder) Counselor
  • San Jose, CA
National Provider Identifier
1558972695
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R1424520421 Issued in CA
Practice address
9505 Malech Dr
San Jose, CA 95138-2002
Phone
(408) 281-6570
Fax
(408) 281-6564
NPI assigned
Aug 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1424520421 CA Primary

Addresses

Primary practice location

9505 Malech Dr
San Jose, CA 95138-2002

Mailing address

1922 The Alameda Ste 316
San Jose, CA 95126-1461
Phone (408) 261-7777

Other practice location 1

2001 The Alameda
San Jose, CA 95126-1136
Phone (408) 261-7777

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

LicenseStateTypeSpecialty
R1424520421CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum for Health PastSince Jan 14, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1558972695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 THE ALAMEDA STE 316",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261461",
            "telephone_number": "408-261-7777",
            "fax_number": "408-642-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9505 MALECH DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951382002",
            "telephone_number": "408-281-6570",
            "fax_number": "408-281-6564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 The Alameda",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951261136",
            "country_code": "US",
            "telephone_number": "408-261-7777",
            "fax_number": "408-259-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTELLO",
        "first_name": "JEANNETTE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1424520421",
            "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 Jan 8, 2024; 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.