Active NPI
Jose L Rodriguez
- Psychologist
- Santa Rosa, CA
National Provider Identifier
1861921991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 1260 N Dutton Ave Ste 225
Santa Rosa, CA 95401-7156 - Phone
- (707) 526-5424
- NPI assigned
- Jun 12, 2017
- Last updated
- Jun 12, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | NU | Primary |
Addresses
Primary practice location
1260 N Dutton Ave Ste 225
Santa Rosa, CA 95401-7156
Mailing address
86 Renato CT Apt 12a
Redwood City, CA 94061-4027
Phone (646) 275-7261
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neuropsychological Assoc of Ca-a Professional Psychological Corp | Past | Accepting new patients | |
| Siyan Clinical Corporation | 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.
-
dba Neuropsychological Associates Of CA
- Clinical Neuropsychologist
- Santa Rosa, CA
- NPI 1508004540
-
- Psychiatry Physician
- Santa Rosa, CA
- NPI 1568732972
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497225600000",
"number": "1861921991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86 RENATO CT APT 12A",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940614027",
"telephone_number": "646-275-7261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1260 N DUTTON AVE STE 225",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954017156",
"telephone_number": "707-526-5424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "JOSE",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-12",
"last_updated": "2017-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.