Individual provider Active NPI

Jennifer Lynn Rodriguez, PSYD

  • Clinical Psychologist
  • St Petersburg, FL
National Provider Identifier
1336397652
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY13109 Issued in FL
Practice address
360 Central Ave Ste 1230
St Petersburg, FL 33701-3865
Phone
(727) 565-2424
NPI assigned
Aug 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY13109 FL Primary

Addresses

Primary practice location

360 Central Ave Ste 1230
St Petersburg, FL 33701-3865

Mailing address

808 N Franklin St Unit 1001
Tampa, FL 33602-3816
Phone (813) 842-4804

Other practice location 1

4175 Lakeside Dr
Ste 110
Richmond, CA 94806-5774
Phone (510) 262-6551

Other practice location 2

10580 Ligon Mill Rd Ste 210
Wake Forest, NC 27587-6090
Phone (919) 263-9592

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

Practice roles

OrganizationSpecialtyStatusNew patients
Perkins Counseling and Psychological Services, PLLC Mental Health PastSince Jun 10, 2012 Accepting new patients
Saible Neuropsychology LLC PastSince Jul 25, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1336397652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 N FRANKLIN ST UNIT 1001",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336023816",
            "telephone_number": "813-842-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 CENTRAL AVE STE 1230",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013865",
            "telephone_number": "727-565-2424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4175 Lakeside Dr",
            "address_2": "Ste 110",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "CA",
            "postal_code": "948065774",
            "country_code": "US",
            "telephone_number": "510-262-6551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10580 Ligon Mill Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Wake Forest",
            "state": "NC",
            "postal_code": "275876090",
            "country_code": "US",
            "telephone_number": "919-263-9592",
            "fax_number": "919-263-9670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY13109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.