Individual provider Active NPI

Arlene Rodriguez

  • Nurse Practitioner
  • Fontana, CA
National Provider Identifier
1649013301
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95027786 Issued in CA
Practice address
17500 Foothill Blvd
Fontana, CA 92335-3736
Phone
(909) 428-0170
NPI assigned
Jun 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP95027786 CA Primary
Registered Nurse 163W00000X 776895 CA

Addresses

Primary practice location

17500 Foothill Blvd
Fontana, CA 92335-3736

Mailing address

17959 Buckeye CT
Fontana, CA 92336-2308
Phone (909) 538-6986

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
I20240913001370 CA Practitioner - Nurse Practitioner 9537609748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unicare Community Health Center, Inc.Group PAC ID 8426369067, 64 clinicians

Practice addresses (Care Compare)

17500 Foothill Blvd
Suite A2
Fontana, CA 92335-3798
Phone (909) 428-0170

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
776895CAMDRegistered Nurse
NP95027786CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unicare Community Health Center Inc Current Accepting new patients
Unicare Community Health Center Inc CurrentSince Sep 3, 2024 Accepting new patients
Unicare Community Health Center, Inc. CurrentSince Sep 3, 2024 Accepting new patients
Joseph M Molina MD Professional Corporation - Southern California PastSince Sep 1, 2024 Accepting new patients

Locations

107 N McKinley St
Corona, CA 92879
Phone (951) 358-0141

17500 Foothill Blvd
Ste A2
Fontana, CA 92335
Phone (909) 428-0170

16127 Foothill Blvd
Fontana, CA 92335
Phone (909) 347-0700

1151 E Walnut St
Ontario, CA 91761
Phone (909) 467-0797

437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835

1501 E Holt Ave
Ste A
Pomona, CA 91767
Phone (909) 623-3600

Interoperability endpoints

  • Direct secure messaging: arlene.rodriguezfnp@mcauc-ca.direct.office.nextgen.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1649013301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17959 BUCKEYE CT",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923362308",
            "telephone_number": "909-538-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17500 FOOTHILL BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353736",
            "telephone_number": "909-428-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ARLENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95027786",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "776895",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.