Jennie Martin, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY27763 Issued in CA

Practice address

Colony Dr
San Luis Obispo, CA 93409-0001

Phone

(805) 547-7900

NPI assigned

Jul 31, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Corrections and Rehabilitation-Headquarters

  • Pharmacy
  • Delano, CA
  • NPI 1942835756
  NPD (past)
• North Kern State Prison

  • Prison Health Clinic/Center
  • Delano, CA
  • NPI 1710350384
  NPD (past)

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711152000000",
    "number": "1972911162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8101",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934098101",
            "telephone_number": "805-547-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COLONY DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934090001",
            "telephone_number": "805-547-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JENNIE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2024-03-23",
        "certification_date": "2024-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27763",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY27763",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Ann Marti
• Danielle Martin-Jensen, SUDRC
• Saxen James Martin-Jensen, APCC, CADC
• Amy Martin, RNFA
• Edith Hashimoto Martin, PHARMD
• Nathan Martin, RPH
• Richard Martin, M.D.
• Victoria Martin
• Stacy Li Martinelli
• Lizeth Geovanni Martinez Valadez

• Clinical Psychologist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2024; 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.