Individual provider Active NPI

Graciela Pilar Rodriguez, LCSW, PSY.D.

  • Clinical Social Worker
  • Aliso Viejo, CA
National Provider Identifier
1740354190
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS13439 Issued in CA
Practice address
6B Liberty
Suite 115
Aliso Viejo, CA 92656-5832
Phone
(949) 472-0226
Fax
(949) 363-9185
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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 LCS13439 CA Primary

Addresses

Primary practice location

6B Liberty
Suite 115
Aliso Viejo, CA 92656-5832

Mailing address

29532 Avante
Laguna Niguel, CA 92677-7949
Phone (949) 472-0226

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS13439CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186272000000",
    "number": "1740354190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29532 AVANTE",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926777949",
            "telephone_number": "949-472-0226",
            "fax_number": "949-363-9185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6B LIBERTY",
            "address_2": "SUITE 115",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565832",
            "telephone_number": "949-472-0226",
            "fax_number": "949-363-9185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "GRACIELA",
        "middle_name": "PILAR",
        "name_prefix": "Dr.",
        "credential": "LCSW, PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS13439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aliso Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; 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.