Active NPI
Fernando Antonio Martinez
- Clinical Social Worker
- Valencia, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW75522
- Practice address
- 23501 Cinema Dr Ste 200
Valencia, CA 91355-5430 - Phone
- (661) 288-4800
- NPI assigned
- Sep 10, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 | |||
| Clinical Social Worker | 1041C0700X | LCSW75522 | CA | Primary |
Addresses
Primary practice location
23501 Cinema Dr Ste 200
Valencia, CA 91355-5430
Mailing address
10605 Balboa Blvd
Ste. 100
Granada Hills, CA 91344-6342
Phone (818) 832-2400
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
10605 Balboa Blvd
Suite 100
Granada Hills, CA 91344-6367
Phone (818) 832-2400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW75522 | CA | MD | Clinical Social Worker |
| 75522 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Los Angeles County Department of Mental Health | Current | Accepting new patients | |
| Los Angeles County Department of Mental Health | Current | Accepting new patients | |
| Los Angeles County Department of Mental Health | Current | Accepting new patients |
Locations
10515 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 486-3837
510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416
10605 Balboa Blvd
Ste 100
San Fernando, CA 91344
Phone (818) 832-2400
23501 Cinema Dr
Ste 210
Valencia, CA 91355
Phone (661) 288-4800
23501 Cinema Dr
Ste 200
Valencia, CA 91355
Phone (661) 288-4800
Organizations & group practices 3
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Los Angeles, CA
- NPI 1083633929
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Granada Hills, CA
- NPI 1699802488
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Arcadia, CA
- NPI 1902676075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613088000000",
"number": "1942559679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10605 BALBOA BLVD",
"address_2": "STE. 100",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "913446342",
"telephone_number": "818-832-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23501 CINEMA DR STE 200",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913555430",
"telephone_number": "661-288-4800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "FERNANDO",
"middle_name": "ANTONIO",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-10",
"last_updated": "2021-02-12",
"certification_date": "2021-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW75522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Valencia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.