Individual provider Active NPI

Ivette Rodriguez

  • Psychologist
  • San Antonio, TX
National Provider Identifier
1083404669
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
39337 Issued in TX
Practice address
1102 Wyoming St
San Antonio, TX 78203-1320
Phone
(210) 995-0234
NPI assigned
May 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 39337 TX Primary

Addresses

Primary practice location

1102 Wyoming St
San Antonio, TX 78203-1320

Mailing address

1102 Wyoming St
San Antonio, TX 78203-1320
Phone (210) 995-0234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250714000437 TX Practitioner - Clinical Psychologist 4284149949 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vcounselors PLLC CurrentSince Apr 29, 2025 Accepting new patients
Alaniz Counseling and Behavioral Center, P.C. CurrentSince Apr 29, 2025 Accepting new patients
Real Talk LLC Past Accepting new patients

Locations

5522 Lone Star Pkwy
Ste 303
San Antonio, TX 78253
Phone (210) 614-4990

17503 La Cantera Pkwy
Ste 104
San Antonio, TX 78257
Phone (210) 564-9116

Organizations & group practices 3

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": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1083404669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 WYOMING ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782031320",
            "telephone_number": "210-995-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 WYOMING ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782031320",
            "telephone_number": "210-995-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "IVETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "39337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.