Individual provider Active NPI

Brenda Guadalupe Martinez Chavez, LCSW

  • Clinical Social Worker
  • Manteca, CA
National Provider Identifier
1801489331
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW129099 Issued in CA
Practice address
165 Saint Dominics Dr Ste 201
Manteca, CA 95337-7802
Phone
(209) 830-4062
Fax
(209) 830-4077
NPI assigned
Feb 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 129099 CA
Clinical Social Worker 1041C0700X LCSW129099 CA Primary

Addresses

Primary practice location

165 Saint Dominics Dr Ste 201
Manteca, CA 95337-7802

Mailing address

PO Box 255228
Sacramento, CA 95865-5228
Phone (800) 470-0071

Other practice location 1

2000 W Briggsmore Ave Ste I
Modesto, CA 95350-3839
Phone (209) 526-1476 ext. 333

Other names 1

  • Brenda Guadalupe Martinez Other name

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
I20260615003607 CA Practitioner - Clinical Social Worker 0446722045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

165 Saint Dominics Dr
Suite 201
Manteca, CA 95337-7802
Phone (209) 823-2345

815 Court St
Jackson, CA 95642-2154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
129099CAMDMental Health Counselor

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": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1801489331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228",
            "telephone_number": "800-470-0071",
            "fax_number": "916-854-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 SAINT DOMINICS DR STE 201",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953377802",
            "telephone_number": "209-830-4062",
            "fax_number": "209-830-4077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 W Briggsmore Ave Ste I",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953503839",
            "country_code": "US",
            "telephone_number": "209-526-1476 x333",
            "fax_number": "209-526-0908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ CHAVEZ",
        "first_name": "BRENDA",
        "middle_name": "GUADALUPE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "129099",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW129099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "MARTINEZ",
            "middle_name": "GUADALUPE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Manteca, CA

Sources for this page

Verify at the official NPI Registry.