Active NPI
Katherine Andrea Rodriguez, MA
- Marriage & Family Therapist
- Fairfield, CA
National Provider Identifier
1174956692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 110239
- Practice address
- 2460 Clay Bank Rd
Fairfield, CA 94533-1655 - Phone
- (707) 399-4820
- NPI assigned
- Aug 20, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 110239 | CA | Primary |
Addresses
Primary practice location
2460 Clay Bank Rd
Fairfield, CA 94533-1655
Mailing address
2460 Clay Bank Rd
Fairfield, CA 94533-1655
Phone (707) 330-6277
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110239 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635292800000",
"number": "1174956692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2460 CLAY BANK RD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945331655",
"telephone_number": "707-330-6277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2460 CLAY BANK RD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945331655",
"telephone_number": "707-399-4820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "KATHERINE",
"middle_name": "ANDREA",
"name_prefix": "Miss",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-20",
"last_updated": "2021-10-27",
"certification_date": "2021-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "110239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.