Dominique Antoinette Martin, RN

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

779452 Issued in CA

Practice address

1542 W 125TH St
Los Angeles, CA 90047-5329

Phone

(424) 230-9000

Fax

(424) 389-7097

NPI assigned

Apr 25, 2019

Last updated

Apr 25, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1710541610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 W 125TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900475329",
            "telephone_number": "424-230-9000",
            "fax_number": "424-389-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 W 125TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900475329",
            "telephone_number": "424-230-9000",
            "fax_number": "424-389-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DOMINIQUE",
        "middle_name": "ANTOINETTE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CA",
            "license": "779452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darriane Martin
• Deborah Martin
• Denise M Martin, NP
• Derek Martin
• Diana Mary Martin, MA OTR
• Elise Martin
• Emily Jean Martin, M.D.
• Frederick Harold Martin Jr., PSY.D.
• Gladys Martin, MD
• Graham Martin, LCSW

• Case Management Registered Nurse in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Case Management Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.