Individual provider Active NPI

Patricia I Rodriguez, LCSW

  • Clinical Social Worker
  • Long Beach, CA
National Provider Identifier
1538179171
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS18541 Issued in CA
Practice address
3939 Atlantic Ave
208
Long Beach, CA 90807-3536
Phone
(310) 488-2093
Fax
(562) 997-0948
NPI assigned
Aug 8, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS18541 CA Primary

Addresses

Primary practice location

3939 Atlantic Ave
208
Long Beach, CA 90807-3536

Mailing address

5851 Premiere Ave
Lakewood, CA 90712-1312
Phone (310) 488-2093

Other identifiers 1

IdentifierTypeStateIssuer
CSW185410MedicaidCA

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050810000674 CA Practitioner - Clinical Social Worker 4981633906 Practice locations: Long Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3939 Atlantic Ave
Suite 208
Long Beach, CA 90807-3535
Phone (310) 488-2093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS18541CAMDClinical Social Worker
18541CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1538179171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5851 PREMIERE AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121312",
            "telephone_number": "310-488-2093",
            "fax_number": "562-997-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 ATLANTIC AVE",
            "address_2": "208",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073536",
            "telephone_number": "310-488-2093",
            "fax_number": "562-997-0948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "PATRICIA",
        "middle_name": "I",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS18541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CSW185410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.