Individual provider Active NPI

Luisa Rodriguez

  • Social Worker
  • Lake Elsinore, CA
National Provider Identifier
1679744254
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
31208 Issued in CA
Practice address
265 San Jacinto River Rd
Suite 107
Lake Elsinore, CA 92530-4400
Phone
(951) 674-9243
NPI assigned
Mar 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 31208 CA Primary

Addresses

Primary practice location

265 San Jacinto River Rd
Suite 107
Lake Elsinore, CA 92530-4400

Mailing address

265 San Jacinto River Rd
Suite 107
Lake Elsinore, CA 92530-4400
Phone (951) 674-9243

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
31208CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1679744254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 SAN JACINTO RIVER RD",
            "address_2": "SUITE 107",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304400",
            "telephone_number": "951-674-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 SAN JACINTO RIVER RD",
            "address_2": "SUITE 107",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304400",
            "telephone_number": "951-674-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LUISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-21",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "31208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.