Individual provider Active NPI

Lizeth Rodriguez, FNP

  • Family Nurse Practitioner
  • Stockton, CA
National Provider Identifier
1518374263
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95030665 Issued in CA
Practice address
701 E Channel St
Stockton, CA 95202-2628
Phone
(209) 944-4700
NPI assigned
Jul 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 757937 CA
Family Nurse Practitioner 363LF0000X 95030665 CA Primary

Addresses

Primary practice location

701 E Channel St
Stockton, CA 95202-2628

Mailing address

212 Dean CT
Brentwood, CA 94513-1075
Phone (415) 516-3785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241203002903 CA Practitioner - Nurse Practitioner 2062947856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
City and County of San FranciscoGroup PAC ID 1658280748, 368 clinicians

Practice addresses (Care Compare)

1351 24TH Ave
Suite 207 208
San Francisco, CA 94122-1616
Phone (415) 682-1991

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
757937CAMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
City & County of San Francisco CurrentSince Dec 22, 2025 Accepting new patients
City and County of San Francisco CurrentSince Dec 22, 2025 Accepting new patients

Locations

1351 24th Ave
Ste 207208
San Francisco, CA 94122
Phone (415) 682-1991

1351 24th Ave
San Francisco, CA 94122
Phone (415) 682-1900

Interoperability endpoints

  • Direct secure messaging: lrodriguez797957@direct.ochin.org
  • Direct secure messaging: lizeth.rodriguez.p1@direct.cmcentersinc.nextgenshare.com

Organizations & group practices 3

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1518374263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 DEAN CT",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945131075",
            "telephone_number": "415-516-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E CHANNEL ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952022628",
            "telephone_number": "209-944-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LIZETH",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "757937",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.