Active NPI
Caroline Rodriguez, PSY
- Psychologist
- Newport Beach, CA
National Provider Identifier
1457078487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 29214
- Practice address
- 4000 Macarthur Blvd Ste 600
Newport Beach, CA 92660-2517 - Phone
- (949) 432-9173
- NPI assigned
- Oct 20, 2022
- 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 |
|---|---|---|---|---|
| Health Service Psychologist | 103TH0100X | 2016008719 | MO | |
| Psychologist | 103T00000X | 29214 | CA | Primary |
Addresses
Primary practice location
4000 Macarthur Blvd Ste 600
Newport Beach, CA 92660-2517
Mailing address
375 Camino de la Reina Apt 340
San Diego, CA 92108-3198
Phone (314) 250-7890
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016008719 | MO | MD | Health Service Psychologist |
| 29214 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666224000000",
"number": "1457078487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 CAMINO DE LA REINA APT 340",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083198",
"telephone_number": "314-250-7890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 MACARTHUR BLVD STE 600",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602517",
"telephone_number": "949-432-9173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "CAROLINE",
"credential": "PSY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-20",
"last_updated": "2022-10-20",
"certification_date": "2022-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "MO",
"license": "2016008719",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "29214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.