Provider Demographics
NPI:1801232905
Name:MARTENS, HEATHER (PHD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:
Last Name:MARTENS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 2ND ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3558
Mailing Address - Country:US
Mailing Address - Phone:760-470-5731
Mailing Address - Fax:
Practice Address - Street 1:533 2ND ST
Practice Address - Street 2:SUITE 114
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3558
Practice Address - Country:US
Practice Address - Phone:760-470-5731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-15
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25605103TM1800X, 103TP2701X, 103TR0400X, 103TC0700X, 103TC2200X, 103TH0004X, 103G00000X, 103TB0200X
103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral