Individual provider Active NPI

Roberto Vicente Martinez

  • Mental Health Counselor
  • Los Angeles, CA
National Provider Identifier
1891289385
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
ASW87240 Issued in CA
Practice address
155 N Occidental Blvd
Los Angeles, CA 90026-4641
Phone
(213) 381-2931
NPI assigned
Jun 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW87240 CA Primary

Addresses

Primary practice location

155 N Occidental Blvd
Los Angeles, CA 90026-4641

Mailing address

155 N Occidental Blvd
Los Angeles, CA 90026-4641
Phone (213) 381-2931

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
ASW87240CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1891289385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N OCCIDENTAL BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264641",
            "telephone_number": "213-381-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N OCCIDENTAL BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264641",
            "telephone_number": "213-381-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ROBERTO",
        "middle_name": "VICENTE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW87240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.