Individual provider Active NPI

Marla Hassinger Martin, PH.D

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1740205061
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY9782 Issued in CA
Practice address
300 UCLA Medical PLZ Ste 1100
Los Angeles, CA 90095-8353
Phone
(310) 825-9989
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY9782 CA
Clinical Psychologist 103TC0700X PSY9782 CA Primary

Addresses

Primary practice location

300 UCLA Medical PLZ Ste 1100
Los Angeles, CA 90095-8353

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 825-9989

Other practice location 1

760 Westwood Plaza
Los Angeles, CA 90095-8353
Phone (310) 825-9989

Other identifiers 1

IdentifierTypeStateIssuer
PSY97820MedicaidCA

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
I20090330000558 CA Practitioner - Clinical Psychologist 9638236003 Reassigns benefits to 1 organization
Practice locations: Reseda, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
9782CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Clinical CurrentSince Jan 9, 2008 Accepting new patients

Locations

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

300 UCLA Medical Plz
Ste 1100
Los Angeles, CA 90095
Phone (310) 825-6501

760 Westwood Plz
Los Angeles, CA 90095
Phone (310) 829-9989

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

300 UCLA Medical Plz
Ste 2200
Los Angeles, CA 90095
Phone (310) 267-6810

300 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-8438

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1740205061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-825-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 UCLA MEDICAL PLZ STE 1100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958353",
            "telephone_number": "310-825-9989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Westwood Plaza",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900958353",
            "country_code": "US",
            "telephone_number": "310-825-9989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MARLA",
        "middle_name": "HASSINGER",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY9782",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY97820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.