Individual provider Active NPI

Roxanne Nicole Pardo

  • Mental Health Counselor
  • Spring Valley, CA
National Provider Identifier
1124636774
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
18713
Practice address
3482 Saddle Dr
Spring Valley, CA 91977-2035
Phone
(619) 564-9661
NPI assigned
Jul 20, 2020
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 18713 Primary
Student in an Organized Health Care Education/Training Program 390200000X
Rehabilitation Practitioner 225400000X

Addresses

Primary practice location

3482 Saddle Dr
Spring Valley, CA 91977-2035

Mailing address

4950 Waring Rd Ste 4
San Diego, CA 92120-2700
Phone (619) 660-3886

Other practice location 1

545 Laurel St
San Diego, CA 92101-1634
Phone (619) 233-4399

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Research Foundation Inc PastSince Feb 4, 2024 Accepting new patients
Center for Positive Changes PastSince Apr 24, 2022 Accepting new patients
Center for Positive Changes Stay PastSince Apr 24, 2022 Accepting new patients
Community Research Foundation Inc PastSince Aug 1, 2020 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1124636774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 WARING RD STE 4",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921202700",
            "telephone_number": "619-660-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3482 SADDLE DR",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919772035",
            "telephone_number": "619-564-9661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Laurel St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921011634",
            "country_code": "US",
            "telephone_number": "619-233-4399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARDO",
        "first_name": "ROXANNE",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "18713",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.