Organization Active NPI

Cross Cultural Services and Evaluations, Inc

  • Clinical Psychologist
  • Santa Rosa, CA
National Provider Identifier
1023505344
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY11538 Issued in CA
Legal business name
CROSS CULTURAL SERVICES AND EVALUATIONS, INC
Practice address
1550 Airport Blvd Ste 206
Santa Rosa, CA 95403-1095
Phone
(707) 799-4274
NPI assigned
Apr 23, 2018
Last updated
Apr 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Authorized official

Name
Rodolfo Rodriguez, PHDNPI 1881871036
Title
Owner
Phone
(707) 799-4274

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY11538 CA Primary

Addresses

Primary practice location

1550 Airport Blvd Ste 206
Santa Rosa, CA 95403-1095

Mailing address

1550 Airport Blvd Ste 206
Santa Rosa, CA 95403-1095
Phone (707) 799-4274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181030002929 CA Part B Supplier - Clinic/Group Practice 5193078665 Receives reassigned benefits from 1 practitioner
Practice locations: Healdsburg, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524441600000",
    "number": "1023505344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 AIRPORT BLVD STE 206",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031095",
            "telephone_number": "707-799-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 AIRPORT BLVD STE 206",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031095",
            "telephone_number": "707-799-4274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSS CULTURAL SERVICES AND EVALUATIONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-04-23",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "RODOLFO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-799-4274",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY11538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.