Individual provider Active NPI

Justine Emerald Martinez, BCBA

  • Behavior Analyst
  • Woodland Hills, CA
National Provider Identifier
1588165013
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
12260266 Issued in CA
Practice address
20259 Ventura Blvd # 259a
Woodland Hills, CA 91364-2551
Phone
(747) 249-1127
NPI assigned
Feb 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 12260266 CA Primary

Addresses

Primary practice location

20259 Ventura Blvd # 259a
Woodland Hills, CA 91364-2551

Mailing address

20259 Ventura Blvd # 259a
Woodland Hills, CA 91364-2551
Phone (747) 249-1127

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
12260266CAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1588165013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20259 VENTURA BLVD # 259A",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913642551",
            "telephone_number": "747-249-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20259 VENTURA BLVD # 259A",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913642551",
            "telephone_number": "747-249-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JUSTINE",
        "middle_name": "EMERALD",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "12260266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.