Jessica Ayesha Rodrigues Sundram

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-09020 Issued in NM

Practice address

200 Rosemont Ave NE Apt C
Albuquerque, NM 87102-1599

Phone

(505) 750-3605

Fax

(505) 340-3941

NPI assigned

Aug 11, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Jessica Rodrigues Sundram Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Inner Path Wellness, LLC

  • Clinical Social Worker
  • Albuquerque, NM
  • NPI 1831617448
  NPD Authorized official

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1841505138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MENAUL BLVD NW STE A PMB 468",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871079951",
            "telephone_number": "505-750-3605",
            "fax_number": "505-340-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ROSEMONT AVE NE APT C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021599",
            "telephone_number": "505-750-3605",
            "fax_number": "505-340-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDRAM",
        "first_name": "JESSICA AYESHA",
        "middle_name": "RODRIGUES",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-09020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40657043",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SUNDRAM",
            "middle_name": "RODRIGUES",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Suncenter Medical Offices, LLC
• Sundance Technologies and Training Center, LLC
• Scott T Sunde, M.D.
• Zoe Sarah Sundell, MD
• Harold B Sunderman, MD
• Sunflower Gardens Homecare
• Sunflower Health and Healing LLC
• Sunita M Rajput DO, LLC
• Sunland Optical Co., Inc.
• Sunny Day Counseling LLC

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.