Active NPI
Roderick Seites Hall, PH.D.
- Clinical Psychologist
- Coronado, CA
National Provider Identifier
1104821479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY15283
- Practice address
- 1224 10TH St
Ste 208
Coronado, CA 92118-3420 - Phone
- (619) 437-0440
- Fax
- (619) 435-6040
- NPI assigned
- Jun 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY15283 | CA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PSY 15283 | CA |
Addresses
Primary practice location
1224 10TH St
Ste 208
Coronado, CA 92118-3420
Mailing address
1224 10TH St
Ste 208
Coronado, CA 92118-3420
Phone (619) 437-0440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- George Washington University School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1224 10TH St
Suite 208
Coronado, CA 92118-3420
Phone (619) 437-0440
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY15283 | CA | MD | Clinical Psychologist |
| PSY 15283 | CA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1104821479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1224 10TH ST",
"address_2": "STE 208",
"city": "CORONADO",
"state": "CA",
"postal_code": "921183420",
"telephone_number": "619-437-0440",
"fax_number": "619-435-6040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1224 10TH ST",
"address_2": "STE 208",
"city": "CORONADO",
"state": "CA",
"postal_code": "921183420",
"telephone_number": "619-437-0440",
"fax_number": "619-435-6040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "RODERICK",
"middle_name": "SEITES",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-14",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY15283",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "PSY 15283",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coronado, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.