Active NPI
Jeanette Marie Rodriguez
- Clinical Social Worker
- Indio, CA
National Provider Identifier
1376837435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW86709
- Practice address
- 47825 Oasis St
Indio, CA 92201-6950 - Phone
- (760) 863-8574
- NPI assigned
- Jun 7, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34187 | CA | |
| Clinical Social Worker | 1041C0700X | LCSW86709 | CA | Primary |
Addresses
Primary practice location
47825 Oasis St
Indio, CA 92201-6950
Mailing address
PO Box 1884
Indio, CA 92202-1884
Phone (760) 702-7450
Other practice location 1
14901 Central Ave
Chino, CA 91710-9500
Phone (909) 597-1821
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 |
|---|---|---|---|
| LCSW86709 | CA | MD | Clinical Social Worker |
| 34187 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651017600000",
"number": "1376837435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1884",
"city": "INDIO",
"state": "CA",
"postal_code": "922021884",
"telephone_number": "760-702-7450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47825 OASIS ST",
"city": "INDIO",
"state": "CA",
"postal_code": "922016950",
"telephone_number": "760-863-8574"
}
],
"practiceLocations": [
{
"address_1": "14901 Central Ave",
"address_purpose": "LOCATION",
"city": "Chino",
"state": "CA",
"postal_code": "917109500",
"country_code": "US",
"telephone_number": "909-597-1821",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "JEANETTE",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-07",
"last_updated": "2022-04-27",
"certification_date": "2022-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "34187",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW86709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.