Individual provider Active NPI

Fabiola Nahir Martinez-Pesante, PHD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1679294599
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
36415 Issued in CA
Practice address
3655 Ruffin Rd Ste 260
San Diego, CA 92123-1860
Phone
(858) 349-8745
NPI assigned
Sep 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 36415 CA Primary

Addresses

Primary practice location

3655 Ruffin Rd Ste 260
San Diego, CA 92123-1860

Mailing address

3655 Ruffin Rd Ste 260
San Diego, CA 92123-1860
Phone (858) 349-8745

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
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1679294599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 RUFFIN RD STE 260",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231860",
            "telephone_number": "858-349-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 RUFFIN RD STE 260",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231860",
            "telephone_number": "858-349-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ-PESANTE",
        "first_name": "FABIOLA",
        "middle_name": "NAHIR",
        "name_prefix": "Miss",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "36415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.