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NICHOLAS RODRIGUEZ
NPI 1174082606
Social Worker - Clinical in Oakland, CA

Active since March 14, 2019Opted out of Medicare · through Mar 24, 2028
516 31ST ST, OAKLAND, CA 94609(510) 613-0330 Get Directions Write a Review

NPPES record last updated: December 3, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 3, 2022, Jan 2, 2021, Sep 9, 2019 and 2 more (5 updates tracked since 2019).

About Nicholas Rodriguez NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICHOLAS RODRIGUEZ (NPI 1174082606) is an individual clinical provider in Oakland, California, licensed in California (112299) and active in the NPI registry since March 2019. He has opted out of Medicare through March 24, 2028 and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1174082606
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameNICHOLAS RODRIGUEZ
Location Address516 31ST STOakland, CA 94609-3204
Mailing Address2930 Domingo Ave # 1360Berkeley, CA 94705-2454
Phone(510) 613-0330
Sole ProprietorYes
Enumeration DateMarch 14, 2019
Last NPPES UpdateDecember 3, 20225 updates tracked since enumeration
NPPES CertifiedDecember 3, 2022
✔ NPI 1174082606 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 112299
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 88425 (CA)
516 31ST ST, Oakland, CA 94609
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Secondary Practice Locations 2

Location 1250 Bon Air RdGreenbrae, CA 94904-1702 · Phone (415) 499-6666
Location 213 Peter Behr DrSan Rafael, CA 94903-5216 · Phone (415) 473-6648

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Nicholas Rodriguez has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 24, 2026 through March 24, 2028.

Opt-Out Effective DateMarch 24, 2026
Opt-Out In Effect ThroughMarch 24, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. DENNIS R. EDWARDS
Marriage & Family Therapist
516 31ST ST
OAKLAND, CA 94609
Alameda County (510) 379-4394
TIFFANY YVETTE PAUL LVN
Licensed Vocational Nurse
516 31ST ST
OAKLAND, CA 94609
Alameda County (510) 379-4179
TAMARA L NEOR ASW
Social Worker (Clinical)
516 31ST ST
OAKLAND, CA 94609
Alameda County (510) 379-4394
AMANDA WHITE ASW 100342
Social Worker (Clinical)
516 31ST ST
OAKLAND, CA 94609
Alameda County (925) 529-4177
ROSE HAMILTON
Counselor
516 31ST ST
OAKLAND, CA 94609
Alameda County (801) 635-4423
BAY AREA COMMUNITY SERVICES, INC.
Community Based Residential Treatment Facility, Mental Illness
516 31ST ST
OAKLAND, CA 94609
Alameda County (510) 613-0330
BAY AREA COMMUNITY SERVICES, INC.
Community Based Residential Treatment Facility, Mental Illness
516 31ST ST
OAKLAND, CA 94609
Alameda County (510) 379-4179
WALTER SERVIUS
Social Worker (Clinical)
516 31ST ST
OAKLAND, CA 94609
Alameda County (510) 318-6112

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Rodriguez's NPI number?

The NPI number for Nicholas Rodriguez is 1174082606. It was assigned to this individual provider in the NPPES registry on March 14, 2019.

Where is Nicholas Rodriguez located?

Nicholas Rodriguez practices at 516 31st St, Oakland, CA 94609. The listed phone number is (510) 613-0330.

What is Nicholas Rodriguez's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Nicholas Rodriguez enrolled in Medicare?

No. Nicholas Rodriguez has opted out of Medicare through March 24, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Nicholas Rodriguez was last updated on December 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.