Active NPI
Fabiola Martinez
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1942488226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 105857
- Practice address
- 3020 Childrens Way # Mc6001
San Diego, CA 92123 - Phone
- (619) 521-3939
- NPI assigned
- Feb 8, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Marriage & Family Therapist | 106H00000X | 105857 | CA | Primary |
Addresses
Primary practice location
3020 Childrens Way # Mc6001
San Diego, CA 92123
Mailing address
3151 Redwood St
San Diego, CA 92104-4615
Phone (619) 521-3939
Other practice location 1
3151 Redwood St
San Diego, CA 92104-4615
Phone (619) 521-3939 ext. 204
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
| License | State | Type | Specialty |
|---|---|---|---|
| 105857 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Diego Youth Services | Past | Accepting new patients | |
| San Diego Youth Services | Case Manager/Care Coordinator | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Voluntary or Charitable Agency
- San Diego, CA
- NPI 1134367337
-
- Case Manager/Care Coordinator
- San Diego, CA
- NPI 1477891257
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569542400000",
"number": "1942488226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3151 REDWOOD ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921044615",
"telephone_number": "619-521-3939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3020 CHILDRENS WAY # MC6001",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92123",
"telephone_number": "619-521-3939"
}
],
"practiceLocations": [
{
"address_1": "3151 Redwood St",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921044615",
"country_code": "US",
"telephone_number": "619-521-3939 x204",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTINEZ",
"first_name": "FABIOLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-08",
"last_updated": "2019-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "105857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.