Organization Active NPI

Alliance Wound Specialist

  • Family Nurse Practitioner
  • Sherman Oaks, CA
National Provider Identifier
1356238158
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ALLIANCE WOUND SPECIALIST
Practice address
15315 Magnolia Blvd Ste 102
Sherman Oaks, CA 91403-1100
Phone
(510) 329-3240
NPI assigned
Jun 23, 2025
Last updated
Jun 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Authorized official

Name
Dr. Clem Dulce Rodriguez, MDNPI 1134394034
Title
Director
Phone
(510) 329-3240

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

15315 Magnolia Blvd Ste 102
Sherman Oaks, CA 91403-1100

Mailing address

15315 Magnolia Blvd Ste 102
Sherman Oaks, CA 91403-1100
Phone (510) 329-3240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250911003243 CA Part B Supplier - Clinic/Group Practice 0648773036 Receives reassigned benefits from 3 practitioners
Practice locations: Sherman Oaks, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1356238158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15315 MAGNOLIA BLVD STE 102",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031100",
            "telephone_number": "510-329-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15315 MAGNOLIA BLVD STE 102",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031100",
            "telephone_number": "510-329-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE WOUND SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "CLEM",
        "authorized_official_middle_name": "DULCE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "510-329-3240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.