Individual provider Active NPI

Joanne Maritza Rodriguez

  • Marriage & Family Therapist
  • Concord, CA
National Provider Identifier
1215510813
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
130517 Issued in CA
Practice address
1070 Concord Ave Ste 109
Concord, CA 94520-5608
Phone
(925) 849-5349
NPI assigned
Apr 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 130517 CA Primary

Addresses

Primary practice location

1070 Concord Ave Ste 109
Concord, CA 94520-5608

Mailing address

1070 Concord Ave Ste 200
Concord, CA 94520-5647
Phone (925) 849-4695

Other practice location 1

1592 Placer Dr
Concord, CA 94521-1828
Phone (925) 787-6253

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260527003104 CA Practitioner - Marriage and Family Therapist 3375013709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
130517CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
La Concordia Psychotherapy and Wellness Clinic CurrentSince May 16, 2021 Accepting new patients
La Concordia Wellness Center Current Accepting new patients
Liberitas Marriage and Family Therapy Marriage & Family Therapist Current Accepting new patients

Locations

1070 Concord Ave
Ste 200
Concord, CA 94520
Phone (925) 300-8600

1070 Concord Ave
Ste 109
Concord, CA 94520
Phone (925) 849-5349

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1215510813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 CONCORD AVE STE 200",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205647",
            "telephone_number": "925-849-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 CONCORD AVE STE 109",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205608",
            "telephone_number": "925-849-5349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1592 Placer Dr",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945211828",
            "country_code": "US",
            "telephone_number": "925-787-6253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOANNE",
        "middle_name": "MARITZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "130517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.