Individual provider Active NPI

Martha Maria Rodriguez

  • Marriage & Family Therapist
  • Covina, CA
National Provider Identifier
1659846004
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
149391 Issued in CA
Practice address
801 W San Bernardino Rd
Covina, CA 91722-3621
Phone
(626) 541-0120
Fax
(626) 608-2624
NPI assigned
Oct 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 149391 CA Primary

Addresses

Primary practice location

801 W San Bernardino Rd
Covina, CA 91722-3621

Mailing address

5185 Marquette Ave
San Bernardino, CA 92407-4623
Phone (323) 378-7534

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

LicenseStateTypeSpecialty
149391CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Family Centered Services Inc. CurrentSince Oct 20, 2024 Accepting new patients

Locations

801 W San Bernardino Rd
Covina, CA 91722
Phone (626) 541-0120

Organizations & group practices 1

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": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1659846004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5185 MARQUETTE AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924074623",
            "telephone_number": "323-378-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W SAN BERNARDINO RD",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917223621",
            "telephone_number": "626-541-0120",
            "fax_number": "626-608-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARTHA",
        "middle_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "149391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.