Individual provider Active NPI

Pheleene Martinez

  • Marriage & Family Therapist
  • Rancho Cucamonga, CA
National Provider Identifier
1730661968
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
136515 Issued in CA
Practice address
9045 Haven Ave
Rancho Cucamonga, CA 91730-5427
Phone
(909) 757-5770
NPI assigned
Sep 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 113790 CA
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X 136515 CA Primary

Addresses

Primary practice location

9045 Haven Ave
Rancho Cucamonga, CA 91730-5427

Mailing address

9045 Haven Ave
Rancho Cucamonga, CA 91730-5427
Phone (909) 757-5770

Other practice location 1

1420 S Milliken Ave Ste 508
Ontario, CA 91761-2337
Phone (909) 988-2418 ext. 4048

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240517001662 CA Practitioner - Marriage and Family Therapist 6608217906 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113790CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Morning View Family Therapy, Inc Marriage & Family Therapist CurrentSince Apr 6, 2024 Accepting new patients

Locations

9065 Haven Ave
Ste 110
Rancho Cucamonga, CA 91730
Phone (909) 757-5770

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1730661968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9045 HAVEN AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305427",
            "telephone_number": "909-757-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9045 HAVEN AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305427",
            "telephone_number": "909-757-5770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1420 S Milliken Ave Ste 508",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "917612337",
            "country_code": "US",
            "telephone_number": "909-988-2418 x4048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "PHELEENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "113790",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "136515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.