Individual provider Active NPI

Maritrini Rodriguez

  • Social Worker
  • San Dimas, CA
National Provider Identifier
1750896387
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCSW125252 Issued in CA
Practice address
180 Via Verde Ste 200
San Dimas, CA 91773-3993
Phone
(909) 599-1227
NPI assigned
Dec 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ACSW95650 CA
Clinical Social Worker 1041C0700X 125252 CA
Social Worker 104100000X LCSW125252 CA Primary

Addresses

Primary practice location

180 Via Verde Ste 200
San Dimas, CA 91773-3993

Mailing address

180 Via Verde Ste 200
San Dimas, CA 91773-3993
Phone (909) 599-1227

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241016004201 CA Practitioner - Clinical Social Worker 1850823758 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Southern California Keck School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

126 N San Gabriel Blvd
San Gabriel, CA 91775-2427
Phone (818) 429-3707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACSW95650CAMDMental Health Counselor
LCSW125252CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Mental Health CurrentSince Oct 22, 2024 Accepting new patients
Harmonae Psychological Services, Inc. CurrentSince Oct 9, 2024 Accepting new patients

Locations

440 E Huntington Dr
Ste 300
Arcadia, CA 91006
Phone (626) 230-4094

155 N Lake Ave
Ste 800
Pasadena, CA 91101
Phone (254) 835-3911

126 N San Gabriel Blvd
San Gabriel, CA 91775
Phone (626) 285-3131

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1750896387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 VIA VERDE STE 200",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733993",
            "telephone_number": "909-599-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 VIA VERDE STE 200",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733993",
            "telephone_number": "909-599-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARITRINI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-05",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ACSW95650",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "125252",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCSW125252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

Verify at the official NPI Registry.