Leilani Urquieta Martin, BS

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

CG60354043 Issued in WA

Practice address

5112 NW Taylor Rd
Bremerton, WA 98312-8837

Phone

(360) 373-2536

Fax

(360) 373-4934

NPI assigned

May 15, 2013

Last updated

May 15, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Leilani Urquieta Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

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.

• Holly Ridge Center

  • Pediatric Physical Therapist
  • Bremerton, WA
  • NPI 1861549206
  NPD (past)

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1952747057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6913 TRACYTON BLVD NW",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983118999",
            "telephone_number": "360-373-2536",
            "fax_number": "360-373-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5112 NW TAYLOR RD",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983128837",
            "telephone_number": "360-373-2536",
            "fax_number": "360-373-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LEILANI",
        "middle_name": "URQUIETA",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "SP60267407",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "CG60354043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020898",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEILANI",
            "last_name": "URQUIETA",
            "credential": "BS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• McKenzie Lynn Marshall
• Nathan Nicholas Marshall
• Rebecca Martin-Dean
• Desiree Marie Martin
• Kayla Martin
• Lott Martin
• Rebekah Nicole Martin
• Sara Martin
• Monica Martinez Reyes
• Jose G Martinez

• Behavior Analyst in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Behavior Analyst in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.