Individual provider Active NPI

Elizabeth Rodriguez, R.N.

  • Adult Psychiatric/Mental Health Registered Nurse
  • Oxnard, CA
National Provider Identifier
1487964797
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
778418 Issued in CA
Practice address
1911 Williams Dr Ste 120
Oxnard, CA 93036-2612
Phone
(805) 981-9270
NPI assigned
Oct 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 778418 CA Primary

Addresses

Primary practice location

1911 Williams Dr Ste 120
Oxnard, CA 93036-2612

Mailing address

2585 Paseo Yolo
Camarillo, CA 93010-2221
Phone (805) 981-9248

Other practice location 1

5810 Ralston St
Ventura, CA 93003-6010
Phone (805) 642-7033 ext. 100

Other practice location 2

4258 Telegraph Rd
Ventura, CA 93003-3706
Phone (805) 477-5700 ext. 5740

Other identifiers 1

IdentifierTypeStateIssuer
163WP0809XMedicaidCA

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
778418CAMDAdult Psychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura PastSince Jul 17, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1487964797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 PASEO YOLO",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102221",
            "telephone_number": "805-981-9248",
            "fax_number": "805-981-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 WILLIAMS DR STE 120",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930362612",
            "telephone_number": "805-981-9270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5810 Ralston St",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930036010",
            "country_code": "US",
            "telephone_number": "805-642-7033 x100",
            "fax_number": "805-642-7201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4258 Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930033706",
            "country_code": "US",
            "telephone_number": "805-477-5700 x5740",
            "fax_number": "805-644-5245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ELIZABETH",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2022-07-13",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "778418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163WP0809X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.