Individual provider Active NPI

Viviana Rodriguez

  • Other Technician
  • San Diego, CA
National Provider Identifier
1508300039
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
License
RBT-15-03520 Issued in CA
Practice address
6540 Lusk Blvd Ste C256
San Diego, CA 92121-5795
Phone
(877) 264-6747
Fax
(877) 539-7730
NPI assigned
Dec 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X RBT-15-03520 CA Primary

Addresses

Primary practice location

6540 Lusk Blvd Ste C256
San Diego, CA 92121-5795

Mailing address

36A Monterey Blvd
San Francisco, CA 94131
Phone (877) 264-6747

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
RBT-15-03520CAMDOther Technician

NPI Registry JSON

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

{
    "created_epoch": "1482105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1508300039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36A MONTEREY BLVD",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94131",
            "telephone_number": "877-264-6747",
            "fax_number": "877-539-7730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6540 LUSK BLVD STE C256",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921215795",
            "telephone_number": "877-264-6747",
            "fax_number": "877-539-7730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "VIVIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-19",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "CA",
            "license": "RBT-15-03520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.