Individual provider Active NPI

Celenia Elaine Rodriguez, NP

  • Nurse Practitioner
  • San Bernardino, CA
National Provider Identifier
1174403828
Registry record updated Nov 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95037009 Issued in CA
Practice address
742 W Highland Ave
San Bernardino, CA 92405-3839
Phone
(909) 881-7320
NPI assigned
Sep 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95037009 CA Primary

Addresses

Primary practice location

742 W Highland Ave
San Bernardino, CA 92405-3839

Mailing address

2873 Valley Blvd
Pomona, CA 91768-2630

Other practice location 1

7576 Sterling Ave
San Bernardino, CA 92410-4273
Phone (909) 381-8983

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2873 Valley Blvd
Pomona, CA 91768-2630

742 W Highland Ave
San Bernardino, CA 92405-3839

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95037009CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Marcos Medical Group Inc. Past Accepting new patients
San Marcos Medical Group Inc. Past Accepting new patients

Organizations & group practices 2

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": "1756944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763856000000",
    "number": "1174403828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2873 VALLEY BLVD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917682630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 W HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924053839",
            "telephone_number": "909-881-7320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7576 Sterling Ave",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924104273",
            "country_code": "US",
            "telephone_number": "909-381-8983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CELENIA",
        "middle_name": "ELAINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-11-23",
        "certification_date": "2025-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95037009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.