Individual provider Active NPI

Cedrick Rockmond Drisdel

  • Rehabilitation Practitioner
  • Lynwood, CA
National Provider Identifier
1326475146
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
2640 Industry Way
Lynwood, CA 90262-4284
Phone
(310) 627-4525
NPI assigned
Oct 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

2640 Industry Way
Lynwood, CA 90262-4284

Mailing address

2640 Industry Way
Lynwood, CA 90262-4284
Phone (310) 627-4525

Other practice location 1

5054 S Vermont Ave
Los Angeles, CA 90037-2946
Phone (323) 373-2444

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

NPI Registry JSON

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

{
    "created_epoch": "1381449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1326475146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624284",
            "telephone_number": "310-627-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624284",
            "telephone_number": "310-627-4525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5054 S Vermont Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900372946",
            "country_code": "US",
            "telephone_number": "323-373-2444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRISDEL",
        "first_name": "CEDRICK",
        "middle_name": "ROCKMOND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-11",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.