Individual provider Active NPI

Joseph Rodriguez, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1881568046
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95036285 Issued in CA
Practice address
480 Tesconi Cir
Santa Rosa, CA 95401-4691
Phone
(707) 206-7268
NPI assigned
Oct 1, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95036285 CA Primary

Addresses

Primary practice location

480 Tesconi Cir
Santa Rosa, CA 95401-4691

Mailing address

480 Tesconi Cir Ste B
Santa Rosa, CA 95401-4691

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260113003744 CA Practitioner - Nurse Practitioner 6608352265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Siyan Clinical CorporationGroup PAC ID 0042470122, 20 clinicians

Practice addresses (Care Compare)

480 Tesconi Cir
Suite B
Santa Rosa, CA 95401-4691
Phone 7072067268109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95036285CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Siyan Clinical Corporation CurrentSince Oct 17, 2025 Accepting new patients

Locations

480 Tesconi Cir
Ste B
Santa Rosa, CA 95401
Phone (707) 206-7268

480 Tesconi Cir
Santa Rosa, CA 95401
Phone (707) 206-7268

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1759276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1881568046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 TESCONI CIR STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 TESCONI CIR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014691",
            "telephone_number": "707-206-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOSEPH",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95036285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.