Roger Grayson Hodge, PSY.D. LCP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

26148 Issued in CA

Practice address

4025 Camino del Rio S Ste 250
San Diego, CA 92108-4100

Phone

(619) 858-3105

Fax

(619) 280-5420

NPI assigned

Sep 22, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Center for Enriching Relationships IncGroup PAC ID 0143506667, 10 clinicians

Practice addresses (Care Compare)

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.

• Center for Enriching Relationships, Inc

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1457591364
  Medicare reassignment Care Compare group NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1124782685
  Medicare reassignment NPD
• Centro de Salud de la Comunidad de San Ysidro Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1457033813
  NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  • Federally Qualified Health Center (FQHC)
  • National City, CA
  • NPI 1598907487
  NPD

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1306096714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2207",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "92021",
            "telephone_number": "760-500-1781",
            "fax_number": "619-449-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 CAMINO DEL RIO S STE 250",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084100",
            "telephone_number": "619-858-3105",
            "fax_number": "619-280-5420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9634 Carlton Hills Blvd.",
            "address_purpose": "LOCATION",
            "city": "Santee",
            "state": "CA",
            "postal_code": "92071",
            "country_code": "US",
            "telephone_number": "760-500-1781",
            "fax_number": "619-449-8923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HODGE",
        "first_name": "ROGER",
        "middle_name": "GRAYSON",
        "credential": "PSY.D. LCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-22",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC44634",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "26148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daisianette Hodge, RN
• Jimmy Hodge
• Michaela Hodge
• Paul Richard Hodge, DPT
• Richard A Hodge, OD
• Brittany Hodges
• Christian R Hodges, LMFT
• Dairrick Hodges
• Elizabeth Hodges
• Isabella A Hodges

• Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.