Individual provider Active NPI

Leticia Rodriguez

  • Clinical Social Worker
  • Victorville, CA
National Provider Identifier
1689116725
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
122121 Issued in CA
Practice address
12640 Hesperia Rd Ste D
Victorville, CA 92395-7753
Phone
(760) 684-4143
Fax
(760) 684-8111
NPI assigned
Nov 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 122121 CA Primary

Addresses

Primary practice location

12640 Hesperia Rd Ste D
Victorville, CA 92395-7753

Mailing address

12640 Hesperia Rd Ste D
Victorville, CA 92395-7753
Phone (760) 684-4143

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240710003329 CA Practitioner - Clinical Social Worker 0648715094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12640 Hesperia Rd
Suite D
Victorville, CA 92395-7753
Phone (760) 684-4143

12830 Hesperia Rd
Suite a D
Victorville, CA 92395-7788
Phone (760) 684-8999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
122121CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tobias Moeller-Bertram MD Corporation CurrentSince Jul 1, 2024 Accepting new patients
Moeller-Bertram Medical Corporation CurrentSince May 1, 2025 Accepting new patients
Tobias Moeller-Bertram MD Corporation CurrentSince Jul 1, 2024 Accepting new patients

Locations

44630 Monterey Ave
Ste 100
Palm Desert, CA 92260
Phone (760) 340-4290

36101 Bob Hope Dr
Ste A1
Rancho Mirage, CA 92270
Phone (760) 321-1315

36101 Bob Hope Dr
Ste A
Rancho Mirage, CA 92270
Phone (760) 321-1315

12830 Hesperia Rd
Ste C
Victorville, CA 92395
Phone (760) 684-8999

12830 Hesperia Rd
Ste Ad
Victorville, CA 92395
Phone (760) 684-8999

12640 Hesperia Rd
Ste D
Victorville, CA 92395
Phone (760) 684-4143

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1689116725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12640 HESPERIA RD STE D",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957753",
            "telephone_number": "760-684-4143",
            "fax_number": "760-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12640 HESPERIA RD STE D",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957753",
            "telephone_number": "760-684-4143",
            "fax_number": "760-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "LETICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-07",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "122121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.