Individual provider Active NPI

Roderick Fields, CADC II

  • Addiction (Substance Use Disorder) Counselor
  • Davis, CA
National Provider Identifier
1477698090
Registry record updated Oct 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
A049760518 Issued in CA
Practice address
212 I Street
Freedom to Choose
Davis, CA 95616
Phone
(530) 601-5959
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 124434 CA
Mental Health Counselor 101YM0800X
Addiction (Substance Use Disorder) Counselor 101YA0400X A049760518 CA Primary
Case Manager/Care Coordinator 171M00000X CA

Addresses

Primary practice location

212 I Street
Freedom to Choose
Davis, CA 95616

Mailing address

212 I Street
Freedom to Choose
Davis, CA 95616
Phone (530) 601-5959

Other practice location 1

900 Fulton Ave
suite 205. TeleCare SOAR
Sacramento, CA 95825-4500
Phone (916) 484-3570 ext. 128

Other names 1

  • Roderick Fields Other name

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

LicenseStateTypeSpecialty
A049760518CAMDAddiction (Substance Use Disorder) Counselor
124434CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1477698090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 I STREET",
            "address_2": "FREEDOM TO CHOOSE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "95616",
            "telephone_number": "530-601-5959",
            "fax_number": "916-484-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 I STREET",
            "address_2": "FREEDOM TO CHOOSE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "95616",
            "telephone_number": "530-601-5959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Fulton Ave",
            "address_2": "suite 205. TeleCare SOAR",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958254500",
            "country_code": "US",
            "telephone_number": "916-484-3570 x128",
            "fax_number": "916-484-3577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "RODERICK",
        "name_prefix": "Mr.",
        "credential": "CADC II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "124434",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A049760518",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RODERICK",
            "last_name": "FIELDS",
            "credential": "CADC II",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 18, 2018; 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.