Healthcare Provider Details

I. General information

NPI: 1336839364
Provider Name (Legal Business Name): MARTIN LOUIS APT PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2386 FARADAY AVE STE 110
CARLSBAD CA
92008-7222
US

IV. Provider business mailing address

PO BOX 602060
SAN DIEGO CA
92160-2060
US

V. Phone/Fax

Practice location:
  • Phone: 877-840-6956
  • Fax: 619-383-6701
Mailing address:
  • Phone: 877-840-6956
  • Fax: 619-383-6701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberMA0310968
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61440868
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95027841
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: