Individual provider Active NPI

Naomi Viviana Rodas, PH.D.

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1770037004
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
33729 Issued in CA
Practice address
4650 W Sunset Blvd # 53
Los Angeles, CA 90027-6062
Phone
(323) 361-3849
NPI assigned
Aug 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Rehabilitation Counselor 225C00000X
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X 33729 CA Primary

Addresses

Primary practice location

4650 W Sunset Blvd # 53
Los Angeles, CA 90027-6062

Mailing address

4650 W Sunset Blvd # 53
Los Angeles, CA 90027-6062
Phone (323) 361-3849

Other practice location 1

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone (310) 829-8265

Other practice location 2

1125 W 6th St
Los Angeles, CA 90017-1833
Phone (323) 361-3621

Other practice location 3

1809 National Ave
San Diego, CA 92113-2113
Phone (619) 515-2300

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
I20230501002356 CA Practitioner - Clinical Psychologist 7517322332 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
33729CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Mar 6, 2023 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Mar 6, 2023 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients

Locations

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 3

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": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1770037004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD # 53",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-3849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SUNSET BLVD # 53",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276062",
            "telephone_number": "323-361-3849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 Santa Monica Blvd",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904042303",
            "country_code": "US",
            "telephone_number": "310-829-8265",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1125 W 6th St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900171833",
            "country_code": "US",
            "telephone_number": "323-361-3621",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1809 National Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921132113",
            "country_code": "US",
            "telephone_number": "619-515-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODAS",
        "first_name": "NAOMI",
        "middle_name": "VIVIANA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-03",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "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": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "33729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.