Individual provider Active NPI

Alyssa Rodriguez

  • Clinical Child & Adolescent Psychologist
  • Philadelphia, PA
National Provider Identifier
1497636211
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Practice address
3550 Market St
Philadelphia, PA 19104-3329
Phone
(913) 626-9405
NPI assigned
Sep 9, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X Primary

Addresses

Primary practice location

3550 Market St
Philadelphia, PA 19104-3329

Mailing address

1001 S 46TH St
Philadelphia, PA 19143-3703
Phone (913) 626-9405

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

NPI Registry JSON

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1497636211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S 46TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191433703",
            "telephone_number": "913-626-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043329",
            "telephone_number": "913-626-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-09-09",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.