Individual provider Active NPI

Jose Pedro Martin, MA

  • Marriage & Family Therapist
  • Walnut Creek, CA
National Provider Identifier
1730338880
Registry record updated Sep 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC15973 Issued in CA
Practice address
307 Lennon LN
Walnut Creek, CA 94598-2418
Phone
(925) 706-1396
NPI assigned
Sep 13, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC15973 CA Primary

Addresses

Primary practice location

307 Lennon LN
Walnut Creek, CA 94598-2418

Mailing address

70 Sunset LN
Berkeley, CA 94708-1554
Phone (510) 527-9798

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC15973CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1221264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221264000000",
    "number": "1730338880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 SUNSET LN",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947081554",
            "telephone_number": "510-527-9798",
            "fax_number": "510-527-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 LENNON LN",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982418",
            "telephone_number": "925-706-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOSE",
        "middle_name": "PEDRO",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-13",
        "last_updated": "2008-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC15973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2008; 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.