Active NPI
Derrick Martin Jr.
- Rehabilitation Counselor
- South San Francisco, CA
National Provider Identifier
1831799972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Counselor
- Practice address
- 306 Spruce Ave
South San Francisco, CA 94080-2741 - Phone
- (650) 589-9305
- Fax
- (650) 589-9330
- NPI assigned
- Oct 28, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Rehabilitation Counselor | 225C00000X | Primary |
Addresses
Primary practice location
306 Spruce Ave
South San Francisco, CA 94080-2741
Mailing address
306 Spruce Ave
South San Francisco, CA 94080-2741
Phone (650) 589-9305
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1831799972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 SPRUCE AVE",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940802741",
"telephone_number": "650-589-9305",
"fax_number": "650-589-9330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 SPRUCE AVE",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940802741",
"telephone_number": "650-589-9305",
"fax_number": "650-589-9330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "DERRICK",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-28",
"last_updated": "2020-10-28",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.