Active NPI
Stephany Melissa Rodriguez
- Behavior Analyst
- Tacoma, WA
National Provider Identifier
1083248488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- WDL118RGF5SB
- Practice address
- 4412 6TH Ave
Tacoma, WA 98406-3500 - Phone
- (253) 393-0369
- NPI assigned
- Feb 25, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | WDL118RGF5SB | WA | Primary |
Addresses
Primary practice location
4412 6TH Ave
Tacoma, WA 98406-3500
Mailing address
5105 Grand Loop Unit 614
Tacoma, WA 98407-3197
Phone (253) 393-0369
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015302576-01 | Other | WA | TRICARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| WDL118RGF5SB | WA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582588800000",
"number": "1083248488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5105 GRAND LOOP UNIT 614",
"city": "TACOMA",
"state": "WA",
"postal_code": "984073197",
"telephone_number": "253-393-0369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4412 6TH AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984063500",
"telephone_number": "253-393-0369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "STEPHANY",
"middle_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-25",
"last_updated": "2020-02-25",
"certification_date": "2020-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WA",
"license": "WDL118RGF5SB",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "015302576-01",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.