Active NPI
Leia Kirsten Rodriguez, MPT
- Physical Therapist
- Rocklin, CA
National Provider Identifier
1588983316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 36702
- Practice address
- 2217 Sunset Blvd
Suite 711
Rocklin, CA 95765-4781 - Phone
- (916) 435-3500
- Fax
- (916) 435-3503
- NPI assigned
- May 18, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 36702 | CA | Primary |
Addresses
Primary practice location
2217 Sunset Blvd
Suite 711
Rocklin, CA 95765-4781
Mailing address
2217 Sunset Blvd
Suite 711
Rocklin, CA 95765-4781
Phone (916) 435-3500
Other names 1
- Leia Kirsten Larsen
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36702 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Physical Therapy Clinics, Inc. | Physical Therapist | Past | Accepting new patients |
| The Physical Therapy Clinics, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Performance Physical Therapy, Aquatic & Hand Rehabilitation
- Physical Therapist
- Rancho Cordova, CA
- NPI 1033136726
-
dba Performance Physical Therapy
- Physical Therapist
- Rancho Cordova, CA
- NPI 1902823693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394409600000",
"number": "1588983316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2217 SUNSET BLVD",
"address_2": "SUITE 711",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "957654781",
"telephone_number": "916-435-3500",
"fax_number": "916-435-3503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2217 SUNSET BLVD",
"address_2": "SUITE 711",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "957654781",
"telephone_number": "916-435-3500",
"fax_number": "916-435-3503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "LEIA",
"middle_name": "KIRSTEN",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-18",
"last_updated": "2014-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "36702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LEIA",
"last_name": "LARSEN",
"middle_name": "KIRSTEN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Rocklin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.