Active NPI
Adrienne Patrice Martin
- Community Health Worker
- San Jose, CA
National Provider Identifier
1578093498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 2001 The Alameda
San Jose, CA 95126-1136 - Phone
- (408) 261-7777
- Fax
- (408) 259-2273
- NPI assigned
- Jun 13, 2017
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
2001 The Alameda
San Jose, CA 95126-1136
Mailing address
504 E William St
San Jose, CA 95112-2211
Phone (510) 778-3154
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 21, 2024 through Aug 21, 2026
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": "1497312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1578093498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 E WILLIAM ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951122211",
"telephone_number": "510-778-3154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 THE ALAMEDA",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951261136",
"telephone_number": "408-261-7777",
"fax_number": "408-259-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ADRIENNE",
"middle_name": "PATRICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-13",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.