John Charles Roedel, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

46086 Issued in CA

Practice address

777 Davis St
San Leandro, CA 94577-6923

Phone

(513) 400-5460

NPI assigned

Jul 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Bay Area Children First- Berkeley

  • Community/Behavioral Health Agency
  • Berkeley, CA
  • NPI 1851591333
  NPD (past)

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1285833962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 DAVIS ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945776923",
            "telephone_number": "513-400-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 DAVIS ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945776923",
            "telephone_number": "513-400-5460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Shattuck Ave",
            "address_2": "Suite 7",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947091411",
            "country_code": "US",
            "telephone_number": "510-883-9312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1433 Covedale Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452383866",
            "country_code": "US",
            "telephone_number": "513-400-5460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROEDEL",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2022-01-03",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35002003A",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "46086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "777 Davis St",
            "city": "San Leandro",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945776923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Natalie Rodriguez
• Olga Lidia Rodriguez
• Priscilla Rodriguez
• Richard Zamarripa Rodriguez, M.D.
• Rutilo Rodriguez Jr.
• Courtney Nicole Rogachevsky, LCSW
• Lynden Salas Rogero, P.T.
• Rachel Dianne Rogers
• Sheena Rogers
• Tamarra Sherell Rogers

• Marriage & Family Therapist in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.