Individual provider Active NPI

Jessica Rodriguez, NP

  • Adult Health Nurse Practitioner
  • El Segundo, CA
National Provider Identifier
1578968731
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95001619 Issued in CA
Practice address
2101 Rosecrans Ave # 3230
El Segundo, CA 90245-4749
Phone
(323) 628-8671
NPI assigned
Oct 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95001619 CA Primary

Addresses

Primary practice location

2101 Rosecrans Ave # 3230
El Segundo, CA 90245-4749

Mailing address

351 S Fuller Ave
Apt 7L
Los Angeles, CA 90036-5451
Phone (323) 717-2408

Other practice location 1

1624 Puente Ave
Baldwin Park, CA 91706-5952
Phone (626) 962-3456

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95001619CAMDCertified Registered Nurse Anesthetist

Interoperability endpoints

  • Direct secure messaging: jrodriguez@landmarkhealth-direct.org
  • Direct secure messaging: jessica.rodriguez.1@32907.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1578968731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 S FULLER AVE",
            "address_2": "APT 7L",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900365451",
            "telephone_number": "323-717-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ROSECRANS AVE # 3230",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454749",
            "telephone_number": "323-628-8671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1624 Puente Ave",
            "address_purpose": "LOCATION",
            "city": "Baldwin Park",
            "state": "CA",
            "postal_code": "917065952",
            "country_code": "US",
            "telephone_number": "626-962-3456",
            "fax_number": "626-962-3404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JESSICA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95001619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.