Individual provider Active NPI

Vanessa Rodriguez

  • Family Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1700230059
Registry record updated Apr 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95003766 Issued in CA
Practice address
3100 Telegraph Ave
Oakland, CA 94609-3239
Phone
(714) 408-0354
NPI assigned
Apr 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95003766 CA Primary

Addresses

Primary practice location

3100 Telegraph Ave
Oakland, CA 94609-3239

Mailing address

6528 Marquette Dr
Buena Park, CA 90620-4623
Phone (714) 408-0354

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160609002508 CA Practitioner - Nurse Practitioner 9537459102 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of California IrvineGroup PAC ID 5395658181, 57 clinicians

Practice addresses (Care Compare)

2441 W la Palma Ave
Anaheim, CA 92801-2658
Phone (657) 282-6356

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95003766CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Irvine Current Accepting new patients
University of California Irvine CurrentSince Feb 10, 2017 Accepting new patients
Regents of the University of CurrentSince Jun 15, 2016 Accepting new patients
University of California Irvine CurrentSince Feb 10, 2017 Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

300 W Carl Karcher Way
Anaheim, CA 92801
Phone (657) 282-6356

2441 W La Palma Ave
Ste 100
Anaheim, CA 92801
Phone (657) 282-6356

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

800 N Main St
Santa Ana, CA 92701
Phone (714) 456-6324

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1700230059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6528 MARQUETTE DR",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204623",
            "telephone_number": "714-408-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 TELEGRAPH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093239",
            "telephone_number": "714-408-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "VANESSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.