Active NPI
Nicholas A Rodriguez
- Occupational Therapy Assistant
- Santa Clara, CA
National Provider Identifier
1508480195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 5696
- Practice address
- 991 Clyde Ave
Santa Clara, CA 95054-1905 - Phone
- (408) 988-7667
- NPI assigned
- May 30, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5696 | CA | Primary |
| Occupational Therapy Assistant | 224Z00000X | 215783 | TX |
Addresses
Primary practice location
991 Clyde Ave
Santa Clara, CA 95054-1905
Mailing address
401 Holland Ave Apt 331
San Antonio, TX 78212-2429
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 215783 | Other | TX | EXECUTIVE COUNCIL OF PHYSICAL THERAPY AND OCCUPATIONAL THERAPY EXAMINERS |
| 5696 | Other | CA | SELF |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 215783 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772064000000",
"number": "1508480195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 HOLLAND AVE APT 331",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782122429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "991 CLYDE AVE",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950541905",
"telephone_number": "408-988-7667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "NICHOLAS",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-30",
"last_updated": "2026-02-26",
"certification_date": "2026-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CA",
"license": "5696",
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "215783",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EXECUTIVE COUNCIL OF PHYSICAL THERAPY AND OCCUPATIONAL THERAPY EXAMINERS",
"identifier": "215783",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELF",
"identifier": "5696",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Santa Clara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.