Active NPI
Alice Rodriguez, LICENSED PROFESSIONA
- Mental Health Counselor
- El Dorado Hills, CA
National Provider Identifier
1184385635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPPC10720
- Practice address
- 1020 Suncast LN
Suite 104
El Dorado Hills, CA 95762-9335 - Phone
- (916) 542-8893
- NPI assigned
- Jan 6, 2022
- Last updated
- Jan 11, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LPPC10720 | CA | |
| Mental Health Counselor | 101YM0800X | LPPC10720 | CA | Primary |
| Professional Counselor | 101YP2500X | LPPC10720 | CA | |
| Psychoanalyst | 102L00000X | LPPC10720 | CA |
Addresses
Primary practice location
1020 Suncast LN
Suite 104
El Dorado Hills, CA 95762-9335
Mailing address
1020 Suncast LN
Suite 104
El Dorado Hills, CA 95762-9335
Phone (916) 542-8893
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPPC10720 | CA | MD | Psychoanalyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641859200000",
"number": "1184385635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 SUNCAST LN",
"address_2": "SUITE 104",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957629335",
"telephone_number": "916-542-8893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 SUNCAST LN",
"address_2": "SUITE 104",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957629335",
"telephone_number": "916-542-8893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "ALICE",
"credential": "LICENSED PROFESSIONA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-06",
"last_updated": "2022-01-11",
"certification_date": "2022-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "LPPC10720",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "LPPC10720",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "LPPC10720",
"primary": false
},
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "CA",
"license": "LPPC10720",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Dorado Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.