Individual provider Active NPI

Kelly R Rodriguez, LMFT

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1902231533
Registry record updated Aug 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
99917 Issued in CA
Practice address
1501 Hughes Way
Suite 150
Long Beach, CA 90810-1876
Phone
(310) 221-6336
NPI assigned
Sep 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2017

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 99917 CA Primary

Addresses

Primary practice location

1501 Hughes Way
Suite 150
Long Beach, CA 90810-1876

Mailing address

1501 Hughes Way
Suite 150
Long Beach, CA 90810-1876
Phone (310) 221-6336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503446400000",
    "number": "1902231533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HUGHES WAY",
            "address_2": "SUITE 150",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908101876",
            "telephone_number": "310-221-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HUGHES WAY",
            "address_2": "SUITE 150",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908101876",
            "telephone_number": "310-221-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "KELLY",
        "middle_name": "R",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2017-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "99917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.