Individual provider Active NPI

Terri Martinez, LCSW

  • Clinical Social Worker
  • Kings Beach, CA
National Provider Identifier
1861935108
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
127061 Issued in CA
Practice address
8678 Cutthroat Ave
Kings Beach, CA 96143-1696
Phone
(530) 205-7311
NPI assigned
Nov 18, 2016
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12072-C NV
Clinical Social Worker 1041C0700X 127061 CA Primary

Addresses

Primary practice location

8678 Cutthroat Ave
Kings Beach, CA 96143-1696

Mailing address

PO Box 1696
Kings Beach, CA 96143-1696
Phone (530) 205-7311

Other practice location 1

11025 Pioneer Trl Unit 101B
Truckee, CA 96161-0250
Phone (530) 285-3335

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
I20250326002270 CA Practitioner - Clinical Social Worker 2668995051 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

4633 Old Ironsides Dr
Suite 304
Santa Clara, CA 95054-1846
Phone (866) 280-0260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12072-CNVMDClinical Social Worker
127061CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Clinical CurrentSince Apr 30, 2025 Accepting new patients
Sud Specialty Group - Ca Addiction (Substance Use Disorder) CurrentSince Mar 13, 2025 Accepting new patients
Granite Wellness Centers Past Accepting new patients
Truckee Therapy Inc Licensed Clinical Social Worker PastSince Apr 27, 2025 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (323) 745-8323

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1861935108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1696",
            "city": "KINGS BEACH",
            "state": "CA",
            "postal_code": "961431696",
            "telephone_number": "530-205-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8678 CUTTHROAT AVE",
            "city": "KINGS BEACH",
            "state": "CA",
            "postal_code": "961431696",
            "telephone_number": "530-205-7311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11025 Pioneer Trl Unit 101B",
            "address_purpose": "LOCATION",
            "city": "Truckee",
            "state": "CA",
            "postal_code": "961610250",
            "country_code": "US",
            "telephone_number": "530-285-3335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "TERRI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-18",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "12072-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "127061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Beach, CA

Sources for this page

Verify at the official NPI Registry.