Individual provider Active NPI

Marcella Rodriguez

  • Marriage & Family Therapist
  • South Pasadena, CA
National Provider Identifier
1104580398
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
143585 Issued in CA
Practice address
205 Pasadena Ave
South Pasadena, CA 91030
Phone
(323) 344-5536
NPI assigned
Oct 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 143585 CA Primary

Addresses

Primary practice location

205 Pasadena Ave
South Pasadena, CA 91030

Mailing address

205 Pasadena Ave
South Pasadena, CA 91030-2919
Phone (323) 344-5536

Other practice location 1

100 W Walnut St Ste 375
Pasadena, CA 91124-0001
Phone (626) 395-7100

Other identifiers 4

IdentifierTypeStateIssuer
7708OtherCAMEDI-CAL
7368OtherCAMEDI-CAL
7184OtherCAMEDI-CAL
7667OtherCAMEDI-CAL

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
143585CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for the Redesign of Learning Marriage & Family Therapist PastSince Mar 31, 2024 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": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1104580398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PASADENA AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302919",
            "telephone_number": "323-344-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PASADENA AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "91030",
            "telephone_number": "323-344-5536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 W Walnut St Ste 375",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911240001",
            "country_code": "US",
            "telephone_number": "626-395-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARCELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "143585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7708",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7368",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7184",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7667",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.