Individual provider Active NPI

Isidro Rodriguez Jr.

  • Addiction (Substance Use Disorder) Counselor
  • Carson, CA
National Provider Identifier
1972789626
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
460 E Carson Plaza Dr
Suite 106
Carson, CA 90746-3228
Phone
(310) 532-6030
Fax
(310) 532-8441
NPI assigned
Jan 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

460 E Carson Plaza Dr
Suite 106
Carson, CA 90746-3228

Mailing address

1342 Ronan Ave
Wilmington, CA 90744-2529
Phone (562) 896-7543

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

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1972789626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 RONAN AVE",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907442529",
            "telephone_number": "562-896-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 E CARSON PLAZA DR",
            "address_2": "SUITE 106",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463228",
            "telephone_number": "310-532-6030",
            "fax_number": "310-532-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ISIDRO",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-11",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.