Active NPI
Martina Danielle Shipp
- Mental Health Counselor
- Pleasanton, CA
National Provider Identifier
1790176030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 101MY0800X
- Practice address
- 3900 Valley Ave
Suite B
Pleasanton, CA 94566-4871 - Phone
- (510) 318-6137
- NPI assigned
- Feb 9, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 101MY0800X | CA | Primary |
Addresses
Primary practice location
3900 Valley Ave
Suite B
Pleasanton, CA 94566-4871
Mailing address
4403 Linden St
Oakland, CA 94608-3419
Phone (510) 459-3173
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101MY0800X | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423440000000",
"number": "1790176030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4403 LINDEN ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946083419",
"telephone_number": "510-459-3173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 VALLEY AVE",
"address_2": "SUITE B",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945664871",
"telephone_number": "510-318-6137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIPP",
"first_name": "MARTINA",
"middle_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-09",
"last_updated": "2015-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "101MY0800X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pleasanton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.