Individual provider Active NPI

Miguel Adrian Rodriguez

  • Marriage & Family Therapist
  • Venice, CA
National Provider Identifier
1053147694
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
161660 Issued in CA
Practice address
503 Ocean Front Walk
Venice, CA 90291-2403
Phone
(310) 392-3070
NPI assigned
Sep 10, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 21997 CA
Marriage & Family Therapist 106H00000X 161660 CA Primary
Case Manager/Care Coordinator 171M00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X CA

Addresses

Primary practice location

503 Ocean Front Walk
Venice, CA 90291-2403

Mailing address

815 N El Centro Ave
Los Angeles, CA 90038-3805
Phone (323) 463-2119

Other practice location 1

815 N El Centro Ave
Los Angeles, CA 90038-3805
Phone (323) 463-2119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
161660CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Houses of Los Angeles, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1053147694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 N EL CENTRO AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900383805",
            "telephone_number": "323-463-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 OCEAN FRONT WALK",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912403",
            "telephone_number": "310-392-3070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 N El Centro Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900383805",
            "country_code": "US",
            "telephone_number": "323-463-2119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MIGUEL",
        "middle_name": "ADRIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-10",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "21997",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "161660",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.