Active NPI
Daniele Nicole Rodriguez, MS
- Speech-Language Pathologist
- Riverside, CA
National Provider Identifier
1942925144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 17205
- Practice address
- 11870 Pierce St Ste 150
Riverside, CA 92505-6600 - Phone
- (951) 808-5850
- NPI assigned
- Oct 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 17205 | CA | Primary |
Addresses
Primary practice location
11870 Pierce St Ste 150
Riverside, CA 92505-6600
Mailing address
11241 Clemson Dr
Rancho Cucamonga, CA 91701-7794
Phone (909) 215-7454
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17205 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lucid Speech & Language | Single Specialty | Past | Accepting new patients |
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": "1665360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665360000000",
"number": "1942925144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11241 CLEMSON DR",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917017794",
"telephone_number": "909-215-7454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11870 PIERCE ST STE 150",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925056600",
"telephone_number": "951-808-5850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "DANIELE",
"middle_name": "NICOLE",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-10",
"last_updated": "2022-10-10",
"certification_date": "2022-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "17205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.