Active NPI
Eve Simone Martin, M.A., M.F.T.
- Marriage & Family Therapist
- Sylmar, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT31711
- Practice address
- 12669 Encinitas Ave
Sylmar, CA 91342-3635 - Phone
- (818) 838-7710
- Fax
- (818) 838-7615
- NPI assigned
- May 16, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT31711 | CA | Primary |
Addresses
Primary practice location
12669 Encinitas Ave
Sylmar, CA 91342-3635
Mailing address
6126 Balcom Ave
Encino, CA 91316-7233
Phone (818) 903-3934
Other practice location 1
6126 Balcom Ave
Encino, CA 91316-7233
Phone (818) 903-3934
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | :https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Kaiser Foundation Health Plan of the Mid Atlantic States, Inc |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12669 Encinitas Ave
Sylmar, CA 91342-3635
Phone (877) 608-0044
13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT31711 | CA | MD | Marriage & Family Therapist |
| 31711 | CA | MD | Independent Medical Examiner Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417
393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235
12669 Encinitas Ave
Sylmar, CA 91342
Phone (800) 700-8705
Organizations & group practices 3
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Lancaster, CA
- NPI 1982863783
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1659588200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6126 BALCOM AVE",
"city": "ENCINO",
"state": "CA",
"postal_code": "913167233",
"telephone_number": "818-903-3934",
"fax_number": "818-758-1360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12669 ENCINITAS AVE",
"city": "SYLMAR",
"state": "CA",
"postal_code": "913423635",
"telephone_number": "818-838-7710",
"fax_number": "818-838-7615"
}
],
"practiceLocations": [
{
"address_1": "6126 Balcom Ave",
"address_purpose": "LOCATION",
"city": "Encino",
"state": "CA",
"postal_code": "913167233",
"country_code": "US",
"telephone_number": "818-903-3934",
"fax_number": "818-758-1360",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTIN",
"first_name": "EVE",
"middle_name": "SIMONE",
"name_prefix": "Ms.",
"credential": "M.A., M.F.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-16",
"last_updated": "2021-12-06",
"certification_date": "2021-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT31711",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": ":https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Kaiser Foundation Health Plan of the Mid Atlantic States, Inc",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "12669 Encinitas Ave",
"city": "Sylmar",
"state": "CA",
"country_code": "US",
"postal_code": "913423635",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Sylmar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.