Active NPI
Adrian Rodriguez, MA
- Marriage & Family Therapist
- Culver City, CA
National Provider Identifier
1770016057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 125302
- Practice address
- 4760 Sepulveda Blvd
Culver City, CA 90230-4820 - Phone
- (310) 390-6612
- Fax
- (310) 398-5690
- NPI assigned
- Apr 4, 2017
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Marriage & Family Therapist | 106H00000X | 125302 | CA | Primary |
Addresses
Primary practice location
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Mailing address
1328 W Manchester Ave
Los Angeles, CA 90044-2240
Phone (323) 778-9595
Other practice location 1
9808 Venice Blvd Ste 505
Culver City, CA 90232-6818
Phone (310) 945-3350
Other practice location 2
108 W Victoria St
Gardena, CA 90248-3523
Phone (310) 715-2020
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125302 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Didi Hirsch Psychiatric Service | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Los Angeles, CA
- NPI 1164553145
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617580800000",
"number": "1770016057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1328 W MANCHESTER AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900442240",
"telephone_number": "323-778-9595",
"fax_number": "323-778-0028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4760 SEPULVEDA BLVD",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902304820",
"telephone_number": "310-390-6612",
"fax_number": "310-398-5690"
}
],
"practiceLocations": [
{
"address_1": "9808 Venice Blvd Ste 505",
"address_purpose": "LOCATION",
"city": "Culver City",
"state": "CA",
"postal_code": "902326818",
"country_code": "US",
"telephone_number": "310-945-3350",
"fax_number": "310-945-3356",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "108 W Victoria St",
"address_purpose": "LOCATION",
"city": "Gardena",
"state": "CA",
"postal_code": "902483523",
"country_code": "US",
"telephone_number": "310-715-2020",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "ADRIAN",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-04",
"last_updated": "2021-04-05",
"certification_date": "2021-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "125302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.