Active NPI
Lola Martin, PSYD
- Psychologist
- Los Angeles, CA
National Provider Identifier
1922649698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 32925
- Practice address
- John Wooden Center West 221 Westwood Plaza
Los Angeles, CA 90095-0001 - Phone
- (310) 825-0768
- NPI assigned
- Oct 3, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychologist | 103T00000X | 32925 | CA | Primary |
Addresses
Primary practice location
John Wooden Center West 221 Westwood Plaza
Los Angeles, CA 90095-0001
Mailing address
John Wooden Center West 221 Westwood Plaza
Los Angeles, CA 90095-0001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 22, 2022 through Aug 22, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32925 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638403200000",
"number": "1922649698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "JOHN WOODEN CENTER WEST 221 WESTWOOD PLAZA",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900950001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "JOHN WOODEN CENTER WEST 221 WESTWOOD PLAZA",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900950001",
"telephone_number": "310-825-0768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "LOLA",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-03",
"last_updated": "2021-12-02",
"certification_date": "2021-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "32925",
"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 Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.