Individual provider Active NPI

Emil Raymond Rodolfa, PH.D.

  • Psychologist
  • Davis, CA
National Provider Identifier
1447425558
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY7805 Issued in CA
Practice address
1 Shields Ave
University of California, Davis (Caps)
Davis, CA 95616-5270
Phone
(530) 752-0871
Fax
(530) 752-9923
NPI assigned
Apr 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY7805 CA Primary

Addresses

Primary practice location

1 Shields Ave
University of California, Davis (Caps)
Davis, CA 95616-5270

Mailing address

1 Shields Ave
University of California, Davis (Caps)
Davis, CA 95616-5270
Phone (530) 752-0871

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY7805CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1447425558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHIELDS AVE",
            "address_2": "UNIVERSITY OF CALIFORNIA, DAVIS (CAPS)",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956165270",
            "telephone_number": "530-752-0871",
            "fax_number": "530-752-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHIELDS AVE",
            "address_2": "UNIVERSITY OF CALIFORNIA, DAVIS (CAPS)",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956165270",
            "telephone_number": "530-752-0871",
            "fax_number": "530-752-9923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODOLFA",
        "first_name": "EMIL",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY7805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.