Active NPI
Edemy Judith Rodriguez
- Mental Health Counselor
- Los Angeles, CA
National Provider Identifier
1649843475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ASW102426
- Practice address
- 155 N Occidental Blvd
Los Angeles, CA 90026-4641 - Phone
- (213) 381-2931
- NPI assigned
- Jul 20, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Mental Health Counselor | 101YM0800X | ASW102426 | CA | Primary |
Addresses
Primary practice location
155 N Occidental Blvd
Los Angeles, CA 90026-4641
Mailing address
155 N Occidental Blvd
Los Angeles, CA 90026-4641
Phone (213) 381-2931
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW102426 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659312000000",
"number": "1649843475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 N OCCIDENTAL BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900264641",
"telephone_number": "213-381-2931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 N OCCIDENTAL BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900264641",
"telephone_number": "213-381-2931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "EDEMY",
"middle_name": "JUDITH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-20",
"last_updated": "2022-08-01",
"certification_date": "2022-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW102426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.