Michael Anthony Rodevich, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY14238 Issued in CA

Practice address

375 Laguna Honda Blvd
Laguna Honda Hospital and Rehab Center, Medical SVCS
San Francisco, CA 94116-1411

Phone

(415) 759-4561

Fax

(415) 759-4587

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1740320852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 LAGUNA HONDA BLVD",
            "address_2": "LAGUNA HONDA HOSPITAL AND REHAB CENTER, MEDICAL SVCS",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941161411",
            "telephone_number": "415-759-2300",
            "fax_number": "415-759-2374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 LAGUNA HONDA BLVD",
            "address_2": "LAGUNA HONDA HOSPITAL AND REHAB CENTER, MEDICAL SVCS",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941161411",
            "telephone_number": "415-759-4561",
            "fax_number": "415-759-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEVICH",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY14238",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "PSY14238",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY14238",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14238",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "CA",
            "license": "PSY14238",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "CA",
            "license": "PSY14238",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY14238",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yanci Rodas
• Sandra Denise Roddy-Adams, D.C.
• Rosalyn Y. Omolade Roddy, LCSW
• Shelby Shabnam Rodef, PHARM.D.
• Ingrid Kathrine Tveit Rodenkirch
• Jonah Rodgers
• Luanna Lorraine Rodgers, M.F.T.
• Maura Rodgers, RD
• Maya Lilnez Rodgers
• Patricia C Rodgers, PA

• Clinical Neuropsychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.