Individual provider Active NPI

Mark Daniel Martinez

  • Behavior Analyst
  • Merced, CA
National Provider Identifier
1811261308
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
240001BN Issued in CA
Practice address
1301 Yosemite Pkwy
Merced, CA 95340-5203
Phone
(209) 722-6335
NPI assigned
Feb 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 240001BN CA Primary

Addresses

Primary practice location

1301 Yosemite Pkwy
Merced, CA 95340-5203

Mailing address

2573 N Parsons Ave
Merced, CA 95340-3210

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

LicenseStateTypeSpecialty
240001BNCAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1811261308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2573 N PARSONS AVE",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953403210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 YOSEMITE PKWY",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953405203",
            "telephone_number": "209-722-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MARK",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-29",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "240001BN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.