Individual provider Active NPI

Christopher L Rodrigo, MFT

  • Marriage & Family Therapist
  • Riverside, CA
National Provider Identifier
1871790543
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT 35317 Issued in CA
Practice address
5225 Canyon Crest Drive
BLDG 100, Suite 103
Riverside, CA 92507
Phone
(951) 248-4000
NPI assigned
Jun 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT 35317 CA Primary

Addresses

Primary practice location

5225 Canyon Crest Drive
BLDG 100, Suite 103
Riverside, CA 92507

Mailing address

30095 Willow Dr
Temecula, CA 92591-3869
Phone (951) 676-5260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • 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
I20240717000879 CA Practitioner - Marriage and Family Therapist 1153866959 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFT 35317CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jun 2, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jun 2, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

5225 Canyon Crest Dr
Riverside, CA 92507
Phone (951) 244-4147

5225 Canyon Crest Dr
Ste 103
Riverside, CA 92507
Phone (951) 248-4000

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, 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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871790543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30095 WILLOW DR",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925913869",
            "telephone_number": "951-676-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 CANYON CREST DRIVE",
            "address_2": "BLDG 100, SUITE 103",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92507",
            "telephone_number": "951-248-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGO",
        "first_name": "CHRISTOPHER",
        "middle_name": "L",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT 35317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.