Individual provider Active NPI

Deborah Rodriguez

  • Marriage & Family Therapist
  • Upland, CA
National Provider Identifier
1083953830
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
102391 Issued in CA
Practice address
1425 W Foothill Blvd
Upland, CA 91786-8007
Phone
(909) 202-9982
NPI assigned
Feb 13, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 102391 CA Primary

Addresses

Primary practice location

1425 W Foothill Blvd
Upland, CA 91786-8007

Mailing address

27261 Las Ramblas Ste 220
Mission Viejo, CA 92691-6468
Phone (909) 202-9982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240920000805 CA Practitioner - Marriage and Family Therapist 1850832684 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Aug 13, 2024 Accepting new patients
Arkadie Counseling and Wellness Center CurrentSince Nov 20, 2025 Accepting new patients
Tri-City Mental Health Center Past Accepting new patients
Tri-City Mental Health Authority PastSince Oct 22, 2019 Accepting new patients

Locations

12139 Mount Vernon Ave
Ste 103
Grand Terrace, CA 92313
Phone (909) 281-9662

3200 E Guasti Rd
Ste 100
Ontario, CA 91761
Phone (877) 414-7739

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 5

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": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1083953830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27261 LAS RAMBLAS STE 220",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916468",
            "telephone_number": "909-202-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 W FOOTHILL BLVD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868007",
            "telephone_number": "909-202-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "DEBORAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-13",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "102391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.