Individual provider Active NPI

Erin Mary Martin, LPC, MFT

  • Marriage & Family Therapist
  • Chino, CA
National Provider Identifier
1780841791
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
40349 Issued in CA
Practice address
11780 Central Ave Ste 100
Chino, CA 91710-6499
Phone
(909) 517-2020
Fax
(909) 517-2022
NPI assigned
May 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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 40349 CA Primary

Addresses

Primary practice location

11780 Central Ave Ste 100
Chino, CA 91710-6499

Mailing address

11780 Central Ave Ste 100
Chino, CA 91710-6499
Phone (909) 517-2020

Other identifiers 1

IdentifierTypeStateIssuer
40349OtherCALMFT LICENSE

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Day Recovery Center, Inc. Marriage & Family Therapist CurrentSince Dec 9, 2019 Accepting new patients
New Day Institute Marriage & Family Therapist PastSince Dec 9, 2019 Accepting new patients

Locations

11780 Central Ave
Ste 100
Chino, CA 91710
Phone (909) 517-2020

Organizations & group practices 2

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": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1780841791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11780 CENTRAL AVE STE 100",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917106499",
            "telephone_number": "909-517-2020",
            "fax_number": "099-517-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11780 CENTRAL AVE STE 100",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917106499",
            "telephone_number": "909-517-2020",
            "fax_number": "909-517-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ERIN",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "LPC, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "40349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMFT LICENSE",
            "identifier": "40349",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.