Individual provider Active NPI

Adrian Rodriguez, MA

  • Marriage & Family Therapist
  • Culver City, CA
National Provider Identifier
1770016057
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
125302 Issued in CA
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

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
125302CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Didi Hirsch Psychiatric Service PastSince Nov 10, 2019 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.

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.

Verify at the official NPI Registry.