MEDICARE: MARTIN LOUIS APT PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61440868	WA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95027841	CA

General Provider Information

NPI Number	:	1336839364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN LOUIS APT PMHNP

Provider Business Mailing Address
First Line	:	PO BOX 602060
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92160-2060
Country	:	US
Telephone Number	:	877-840-6956
Fax Number	:	619-383-6701

Provider Business Practice Location Address
First Line	:	2386 FARADAY AVE STE 110
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-7222
Country	:	US
Telephone Number	:	877-840-6956
Fax Number	:	619-383-6701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2023
Last Update Date	:	03/24/2026

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