JACK MARTIN (NPI# 1417592817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417592817 |
| Entity Type | Individual |
| Full Name | JACK MARTIN |
| Credential | RADT |
| Practice Address |
5675 W Olympic Blvd Los Angeles CA 90036-4712 |
| Practice Telephone | 3236847089 |
| Enumeration Date | 2019-11-10 |
| Last Update Date | 2019-11-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073707998 | Jack Frederick Martin Sr. | Orthopaedic Surgery | 1220 Aspen Way, Jack F Martin Md, Petoskey, MI 49770 | 2007-09-04 |
| 1700915279 | Jack Kennard Martin | Chiropractor | 203 S Bridge St, Dewitt, MI 48820-8911 | 2007-03-02 |
| 1003914342 | Jack Richard Martin | Chiropractor | 1601 East Main Street, Suite 1b, St Charles, IL 60174 | 2006-09-20 |
| 1942206214 | Jack L Martin | Internal Medicine | 18615 Tuscany Stone, Suite 170, San Antonio, TX 78258-3498 | 2005-06-22 |
| 1255574521 | Jack Robert Martin | Psychologist | 1300 National Dr, Suite 170, Sacramento, CA 95834-1947 | 2009-04-15 |
| 1831309269 | Jack Martin | Counselor | 5934 S Staples St, Suite 210, Corpus Christi, TX 78413-3842 | 2007-05-23 |
| 1790879765 | Jack W. Martin | Dentist | 1515 Holcombe Blvd, Houston, TX 77030-4009 | 2006-10-03 |
| 1932159878 | Jack T. Martin | Radiology | 4518 Union Deposit Rd, Harrisburg, PA 17111-2910 | 2006-05-11 |
| Street Address |
5675 W OLYMPIC BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90036-4712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841429669 | Chabad Residential Treatment Center | Substance Abuse Rehabilitation Facility | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2009-07-14 |
| 1215544135 | Jordan Alexander Escobar | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-09-24 |
| 1437765377 | Kevin Lytvak | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-09-16 |
| 1447868302 | Jay Michael Small | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-07-16 |
| 1588281752 | Joshua Daniel Mulnick | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-07-02 |
| 1831715242 | Kalina Noelle | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-06-22 |
| 1588287684 | Shimon Dusowitz | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-05-22 |
| 1174144638 | Eduardo Javier Martinez | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-05-06 |
| 1164053914 | Aron Yakovlev | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-01-30 |
| 1184264467 | Matthew John Stenger | Counselor | 5675 W Olympic Blvd, Los Angeles, CA 90036-4712 | 2020-01-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140198 | Stephanie N Carter | Dietitian, Registered | 460 Burnside Ave, Apt 8k, Los Angeles, CA 90036 | 2020-06-26 |
| 1609492107 | Katherine Niemela | Registered Nurse | 5619 W 4th St, Suite 5, Los Angeles, CA 90036 | 2020-06-19 |
| 1508384330 | Matthew Milstein | Psychologist | 5675 West Olympic Blvd., Los Angeles, CA 90036 | 2017-08-31 |
| 1912423963 | John Allen Ostlund | Counselor | 5675 W. Olympic Blvd, Los Angeles, CA 90036 | 2017-08-21 |
| 1306376629 | Scott William Wilson | Case Manager/Care Coordinator | 1891 N. Gaffey Street Suite 219 & 221, San Pedro, CA 90036 | 2017-06-19 |
| 1205382298 | Janice Payson | Marriage & Family Therapist | 801 South Spaulding Avenue, Suite A, Los Angeles, CA 90036 | 2016-08-30 |
| 1134577281 | Parul A Desai | Registered Nurse | 5800 Wilshire Blvd, Los Angeles, CA 90036 | 2016-05-31 |
| 1477914604 | Sarah Frank Jarvis | Marriage & Family Therapist | 7421 Beverly Blvd Ste 2, Los Angeles, CA 90036 | 2016-03-16 |
| 1558747162 | Paul Oberon, Psy.d, Inc. | Community/Behavioral Health | 7421 Beverly Blvd., #10, Los Angeles, CA 90036 | 2015-08-05 |
| 1235543117 | Benjamin Maixner | Behavioral Analyst | 441 1/2 N Curson Ave, Los Angeles, CA 90036 | 2014-06-18 |
| Find all providers in zip 90036 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457377 | Marian Locke | Counselor | 3901 W Adams Blvd, Los Angeles, CA 90018-1756 | 2020-11-05 |
| 1871193888 | Daniel Luna | Counselor | 811 Beacon Ave, Los Angeles, CA 90017-2113 | 2020-10-28 |
| 1962000240 | Frederick P Delafield Iv | Counselor | 679 1/2 Levering Ave, Los Angeles, CA 90024-2350 | 2020-10-09 |
| 1578179941 | Leo Vasquezawarez | Counselor | 470 E 3rd St # Ab, Los Angeles, CA 90013-1629 | 2020-09-21 |
| 1801401963 | Manuel Gambino | Counselor | 11301 Wilshire Blvd Bldg 337, Los Angeles, CA 90073-1003 | 2020-09-14 |
| 1871107219 | Frances Field | Counselor | 3739 Mentone Ave Apt 7, Los Angeles, CA 90034-6444 | 2020-09-02 |
| 1730707985 | Lucia Miguel | Counselor | 1428 W 59th St, Los Angeles, CA 90047-1209 | 2020-07-13 |
| 1821615220 | Sarah Payne | Counselor | 3217 North Eastern Ave, Los Angeles, CA 90032 | 2020-07-01 |
| 1376168070 | Mercedes Elkoff | Counselor | 1745 Warnall Ave, Los Angeles, CA 90024-5358 | 2020-06-09 |
| 1508481201 | Jeanine Ingram | Counselor | 3815 Lockland Dr, Los Angeles, CA 90008-3533 | 2020-06-09 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90036 |
Please comment or provide details below to improve the information on JACK MARTIN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.