Roselyn Rodriguez Smith, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12383 Issued in CA

Practice address

1520 Nutmeg PL Ste 101
Costa Mesa, CA 92626-2557

Phone

(714) 922-4194

NPI assigned

Sep 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• Planned Parenthood/Orange and San Bernardino Counties, Inc.

  • Clinic/Center
  • Anaheim, CA
  • NPI 1710975727
  NPD (past)

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1649464397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 513980",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900513980",
            "telephone_number": "714-456-2911",
            "fax_number": "714-456-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 NUTMEG PL STE 101",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262557",
            "telephone_number": "714-922-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROSELYN",
        "middle_name": "RODRIGUEZ",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA12383",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA12383",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA12383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Marie Smith, LMFT
• Jordan Smith
• Linda Kimberly Smith, CSWI
• Meghan Mackenzie Smith, PNP
• Naomi Sky Smith
• Tiffany Sue Smith
• Dianne Smyth
• Theresa Anne Marie Sniadowski, M.D.
• Alexus Snowden, BA
• Ashley Snyder

• Physician Assistant in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.