Active NPI
Manuel D Rodriguez, BCABA
- Behavior Analyst
- North Hills, CA
National Provider Identifier
1750668075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-17-26630
- Practice address
- 16713 Roscoe Blvd
North Hills, CA 91343-6110 - Phone
- (800) 418-9319
- Fax
- (800) 861-3759
- NPI assigned
- Nov 15, 2011
- Last updated
- Oct 25, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-17-26630 | CA | Primary |
Addresses
Primary practice location
16713 Roscoe Blvd
North Hills, CA 91343-6110
Mailing address
11930 Amargosa Rd. Suite 1
#1037
Victorvillle, CA 92392
Phone (661) 974-4496
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Pathways, Inc. | Behavior Analyst | Current | Accepting new patients |
| Wellspring Healthcare Services, Inc. | Past | Accepting new patients |
Locations
11930 Amargosa Rd
Ste 1
Victorville, CA 92392
Phone (734) 478-1809
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- North Hills, CA
- NPI 1891939005
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698192000000",
"number": "1750668075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11930 AMARGOSA RD. SUITE 1",
"address_2": "#1037",
"city": "VICTORVILLLE",
"state": "CA",
"postal_code": "92392",
"telephone_number": "661-974-4496",
"fax_number": "213-214-0629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16713 ROSCOE BLVD",
"city": "NORTH HILLS",
"state": "CA",
"postal_code": "913436110",
"telephone_number": "800-418-9319",
"fax_number": "800-861-3759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "MANUEL",
"middle_name": "D",
"credential": "BCABA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-15",
"last_updated": "2023-10-25",
"certification_date": "2023-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-17-26630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.