Rodolfo Alvarado, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Reseda, CA
NPI 1790248276 · NPPES record last updated Jan 27, 2026
Key facts
- NPI
- 1790248276
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 95038294 (CA)
- Practice address
- 18107 Sherman Way Ste 200
Reseda, CA 91335-8802 - Phone
- (818) 783-1002
- NPI assigned
- Apr 10, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Ehab Yacoub MD Inc
Practice addresses (Care Compare)
1225 W 190TH St
Suite 280
Gardena, CA 90248-4305
Phone (877) 515-8113
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260327003351 | CA | Practitioner - Nurse Practitioner | 8224513288 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95038294 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ehab Yacoub MD Inc. | Current |
Accepting new patients | |
| Roze Room Hospice of the Valley Inc | Past | Accepting new patients |
Locations
1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113
155 N Lake Ave
Fl 8
Pasadena, CA 91101
Phone (626) 667-0935
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95038294 | CA | Yes |
Addresses
Primary practice location
18107 Sherman Way Ste 200
Reseda, CA 91335-8802
Mailing address
8119 McNulty Ave
Winnetka, CA 91306-1733
Phone (818) 456-9311
Other providers in Reseda, CA
- Robelyn Andales Almazon
- Daisy Alonzo
- Karla Alonzo
- Altus Home Health Agency Inc
- Aludra Inc.
- Tammy M Alvarez
- Anthony J. Amado
- Isela Amaya
- Sheenie Ambardar
- Joyce Ambrosia
All providers in Reseda, CA · Psychiatric/Mental Health Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.