Individual provider Active NPI

Eduardo Rodriguez

  • Clinical Social Worker
  • Duarte, CA
National Provider Identifier
1255717633
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
126868 Issued in CA
Practice address
1801 Huntington Dr
Duarte, CA 91010-2686
Phone
(626) 993-3000
Fax
(266) 288-1026
NPI assigned
Aug 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 96222 CA
Social Worker 104100000X ASW96222 CA
Rehabilitation Practitioner 225400000X
Clinical Social Worker 1041C0700X 126868 CA Primary

Addresses

Primary practice location

1801 Huntington Dr
Duarte, CA 91010-2686

Mailing address

1509 W Cameron Ave Ste 230
West Covina, CA 91790-2725
Phone (626) 993-3000

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

State licenses

LicenseStateTypeSpecialty
ASW96222CAMDSocial Worker
126868CAMDClinical Social Worker
96222CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1255717633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 W CAMERON AVE STE 230",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902725",
            "telephone_number": "626-993-3000",
            "fax_number": "266-288-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 HUNTINGTON DR",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102686",
            "telephone_number": "626-993-3000",
            "fax_number": "266-288-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "EDUARDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-07",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "96222",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW96222",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "126868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duarte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.