Individual provider Active NPI

Stacie Ranee Martinez

  • Marriage & Family Therapist
  • Sacramento, CA
National Provider Identifier
1639186190
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT46781 Issued in CA
Practice address
8912 Volunteer LN
Sacramento, CA 95826-3221
Phone
(916) 344-0199
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 38704 CA
Marriage & Family Therapist 106H00000X LMFT46781 CA Primary

Addresses

Primary practice location

8912 Volunteer LN
Sacramento, CA 95826-3221

Mailing address

149 Brookwater CT
Roseville, CA 95747-5959

Other practice location 1

5777 Madison Ave Ste 240
Sacramento, CA 95841-3308
Phone (916) 344-0964

Other identifiers 1

IdentifierTypeStateIssuer
000008462OtherCAMEDI-CAL PROVIDER #

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
LMFT46781CAMDMarriage & Family Therapist
38704CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1639186190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 BROOKWATER CT",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957475959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8912 VOLUNTEER LN",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958263221",
            "telephone_number": "916-344-0199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5777 Madison Ave Ste 240",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958413308",
            "country_code": "US",
            "telephone_number": "916-344-0964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "STACIE",
        "middle_name": "RANEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "38704",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT46781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER #",
            "identifier": "000008462",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.

Verify at the official NPI Registry.