Individual provider Active NPI

Laura Rivera Rodriguez

  • Student in an Organized Health Care Education/Training Program
  • Oakland, CA
National Provider Identifier
1841679750
Registry record updated Sep 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1727 Martin Luther King Jr Way Ste 109
Oakland, CA 94612-1358
Phone
(510) 893-9230
NPI assigned
May 26, 2015
Last updated
Sep 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1727 Martin Luther King Jr Way Ste 109
Oakland, CA 94612-1358

Mailing address

1727 MLK Jr Way Ste 109
Oakland, CA 94612-1358

Other practice location 1

11133 Washington Blvd.
Culver City, CA 90232
Phone (310) 895-2360

Other names 1

  • Laura Rivera Other name

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
I20240102002645 CA Practitioner - Marriage and Family Therapist 4082064159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Institute for Psychological ServicesGroup PAC ID 0446224893, 4 clinicians

Practice addresses (Care Compare)

110 Gough St
Suite 301
San Francisco, CA 94102-5971
Phone (415) 861-5449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Didi Hirsch Psychiatric Service Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599264000000",
    "number": "1841679750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 MLK JR WAY STE 109",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 MARTIN LUTHER KING JR WAY STE 109",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121358",
            "telephone_number": "510-893-9230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11133 Washington Blvd.",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "90232",
            "country_code": "US",
            "telephone_number": "310-895-2360",
            "fax_number": "310-895-2395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA RODRIGUEZ",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-26",
        "last_updated": "2020-09-05",
        "certification_date": "2020-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "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": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "RIVERA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.