Active NPI
Marta E Wild, MD
- Psychiatry Physician
- Long Beach, CA
National Provider Identifier
1659463305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- D0032863
- Practice address
- 1301 Pine Ave
Long Beach, CA 90813-3124 - Phone
- (562) 595-1159
- NPI assigned
- Sep 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 176524 | CA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | D0032863 | MD | |
| Psychiatry Physician | 2084P0800X | D0032863 | MD | Primary |
Addresses
Primary practice location
1301 Pine Ave
Long Beach, CA 90813-3124
Mailing address
2509 Rochelle Dr
Fallston, MD 21047-2208
Other practice location 1
4441 E Kings Canyon Rd
Fresno, CA 93702-3604
Phone (559) 600-9180
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0032863 | MD | MD | Psychiatry Physician |
| 176524 | CA | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742169600000",
"number": "1659463305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2509 ROCHELLE DR",
"city": "FALLSTON",
"state": "MD",
"postal_code": "210472208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 PINE AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908133124",
"telephone_number": "562-595-1159"
}
],
"practiceLocations": [
{
"address_1": "4441 E Kings Canyon Rd",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937023604",
"country_code": "US",
"telephone_number": "559-600-9180",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILD",
"first_name": "MARTA",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-29",
"last_updated": "2025-03-17",
"certification_date": "2025-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "176524",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MD",
"license": "D0032863",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "D0032863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.