Individual provider Active NPI

Erica Natalie Michelle Rodriguez, FNP-C

  • Family Nurse Practitioner
  • Pomona, CA
National Provider Identifier
1194449439
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95022666 Issued in CA
Practice address
1196 N Park Ave
Pomona, CA 91768-3027
Phone
(909) 623-4050
NPI assigned
Sep 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95022666 CA Primary

Addresses

Primary practice location

1196 N Park Ave
Pomona, CA 91768-3027

Mailing address

1371 Sycamore St
Ontario, CA 91764-1412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230814002686 CA Practitioner - Nurse Practitioner 3173985751 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mallu Reddy, M.D. Inc. CurrentSince Jun 20, 2023 Accepting new patients
Mallu Reddy MD Inc Family CurrentSince Jun 20, 2023 Accepting new patients

Locations

1196 N Park Ave
Pomona, CA 91768
Phone (909) 623-4050

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

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": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1194449439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 SYCAMORE ST",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917641412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1196 N PARK AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917683027",
            "telephone_number": "909-623-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ERICA",
        "middle_name": "NATALIE MICHELLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95022666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.