Active NPI
Juan Rodriguez, LCSW
- Clinical Social Worker
- South Lake Tahoe, CA
National Provider Identifier
1689486110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 127365
- Practice address
- PO Box 18033
South Lake Tahoe, CA 96151-8033 - Phone
- (530) 601-6318
- NPI assigned
- Jan 22, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 127365 | CA | Primary |
Addresses
Primary practice location
PO Box 18033
South Lake Tahoe, CA 96151-8033
Mailing address
PO Box 18033
South Lake Tahoe, CA 96151-8033
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 |
|---|---|---|---|
| 127365 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737504000000",
"number": "1689486110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18033",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961518033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 18033",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961518033",
"telephone_number": "530-601-6318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "JUAN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-01-22",
"last_updated": "2025-01-22",
"certification_date": "2025-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "127365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Lake Tahoe, CA
- Rite of Passage Adolescent Treatment Centers and Schools, Inc. (California Qualifying Houses - Tallac)
- Sara Robison
- Jacob Daniel Rodgers
- Blake Fung Rodman
- Christina Rodriguez
- Roger Rogalski MD CHTD
- Rollie E Rohnow, RPH
- Rebecca Renee Rojas
- Ronald M Gemberling MD Inc
- Root & Return Therapy, a Licensed Clinical Social Worker Professional Corporation
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.