Active NPI
David Rodriguez
- Marriage & Family Therapist
- Commerce, CA
National Provider Identifier
1306062179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF52883
- Practice address
- 2450 S Atlantic Blvd
# 101
Commerce, CA 90040-1200 - Phone
- (323) 318-9960
- NPI assigned
- Apr 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF52883 | CA | Primary |
Addresses
Primary practice location
2450 S Atlantic Blvd
# 101
Commerce, CA 90040-1200
Mailing address
3223 Andrita St
Apt 4
Los Angeles, CA 90065-2075
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SFS6219 | Other | CA | DMH IDENTIFIER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| IMF52883 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Penny Lane | Past | Accepting new patients | |
| Penny Lane | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Commerce, CA
- NPI 1043491756
-
- Community/Behavioral Health Agency
- Commerce, CA
- NPI 1558664631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306062179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3223 ANDRITA ST",
"address_2": "APT 4",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900652075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 S ATLANTIC BLVD",
"address_2": "# 101",
"city": "COMMERCE",
"state": "CA",
"postal_code": "900401200",
"telephone_number": "323-318-9960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF52883",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMH IDENTIFIER",
"identifier": "SFS6219",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Commerce, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.