Active NPI
Amber Martin
- Marriage & Family Therapist
- Soquel, CA
National Provider Identifier
1972902435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 104655
- Practice address
- 5905 Soquel Dr Ste 600
Soquel, CA 95073-2861 - Phone
- (626) 234-5113
- NPI assigned
- Aug 20, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 104655 | CA | Primary |
Addresses
Primary practice location
5905 Soquel Dr Ste 600
Soquel, CA 95073-2861
Mailing address
719 Capitola Ave Apt a
Capitola, CA 95010-2773
Phone (626) 234-5113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104655 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519257600000",
"number": "1972902435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 CAPITOLA AVE APT A",
"city": "CAPITOLA",
"state": "CA",
"postal_code": "950102773",
"telephone_number": "626-234-5113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5905 SOQUEL DR STE 600",
"city": "SOQUEL",
"state": "CA",
"postal_code": "950732861",
"telephone_number": "626-234-5113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "AMBER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-20",
"last_updated": "2018-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "104655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Soquel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; 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.