EDDIE RUDOLPH (NPI# 1164763025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164763025 |
| Entity Type | Individual |
| Full Name | EDDIE RUDOLPH |
| Practice Address |
3881 S Western Ave Los Angeles CA 90062-1105 |
| Mailing Address |
3175 S Hoover St Apt #343 Los Angeles CA 90007-3196 |
| Practice Telephone | 3232904348 |
| Mailing Telephone | 3235227030 |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2013-03-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3881 S WESTERN AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90062-1105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508905167 | Galen M Babb | Counselor | 3881 S Western Ave, Los Angeles, CA 90062-1105 | 2007-02-06 |
| 1720694987 | Munju Anna Chung | Counselor | 3881 S Western Ave, Los Angeles, CA 90062-1105 | 2020-09-22 |
| 1326663634 | Tre' Jor La'nae Hyde | Counselor | 3881 S Western Ave, Los Angeles, CA 90062-1105 | 2020-06-11 |
| 1174145577 | Cereina Diana,aniece Hawkins | Licensed Vocational Nurse | 3881 S Western Ave, Los Angeles, CA 90062-1105 | 2020-05-08 |
| 1043850308 | Oluwadamilola Akinyelure | Case Manager/Care Coordinator | 3881 S Western Ave, Los Angeles, CA 90062-1105 | 2020-01-14 |
| 1881237303 | Emily Gann | Counselor | 3881 S Western Ave, Los Angeles, CA 90062-1105 | 2019-10-28 |
| 1679129415 | Shaydra Torres | Counselor | 3881 S Western Ave, Los Angeles, CA 90062-1105 | 2019-08-16 |
| 1558829044 | Keeley Marie Ahearn | Counselor | 3881 S Western Ave, Los Angeles, CA 90062-1105 | 2019-03-04 |
| 1134695356 | Gabriela Casillas Liceaga | Case Manager/Care Coordinator | 3881 S Western Ave, Los Angeles, CA 90062-1105 | 2018-10-15 |
| 1144704750 | Jaime Jose Mendoza | Case Manager/Care Coordinator | 3881 S Western Ave, Los Angeles, CA 90062-1105 | 2018-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386298867 | Prompt Healthcare, Inc., A Medical Corporation | Family Medicine | 1972 West 48th Street, #a, Los Angeles, CA 90062 | 2019-08-01 |
| 1083194773 | Day One Detox Center, Inc | Substance Abuse Rehabilitation Facility | 1421 W 46th St, Los Angeles, CA 90062 | 2018-08-21 |
| 1457863706 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1537 W 49th St, Los Angeles, CA 90062 | 2017-10-26 |
| 1639680259 | The Dream Catcher Foundation, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1762 W 42nd St, Los Angeles, CA 90062 | 2017-10-23 |
| 1033535794 | Trusana Monique Hall | Licensed Vocational Nurse | 4103 S. Halldale Ave, Los Angeles, CA 90062 | 2014-03-05 |
| 1093139644 | Daniel Garcia | Rehabilitation Practitioner | 3381 Western Ave., Los Angeles, CA 90062 | 2014-02-18 |
| 1689003790 | Crystal Vernon | Case Manager/Care Coordinator | 3881 S. Western Avenue, Los Angeles, CA 90062 | 2013-11-08 |
| 1184902934 | Gerry Lynn Lockhart | Case Manager/Care Coordinator | 3881 S Western Avenue, Los Angeles, CA 90062 | 2011-07-28 |
| 1285921692 | Atlantic Recovery Services | Community/Behavioral Health | 1701 Browning Street, Los Angeles, CA 90062 | 2011-07-06 |
| 1174796452 | Tacora Leggett | Counselor | 5311 S Western Avenue, Los Angeles, CA 90062 | 2008-04-08 |
| Find all providers in zip 90062 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861013757 | Terrisa Noel-rivera Luna | Rehabilitation Practitioner | 11303 Wilshire Blvd Bld 116, Los Angeles, CA 90025-5069 | 2020-05-01 |
| 1063046795 | Leanne Margaret Cremin | Rehabilitation Practitioner | 2285 Westwood Blvd, Los Angeles, CA 90064-2017 | 2020-03-03 |
| 1720610421 | Ronmoe Inc | Rehabilitation Practitioner | 2025 Westwood Blvd, Los Angeles, CA 90025-6328 | 2020-02-10 |
| 1104390723 | Joana Rodriguez | Rehabilitation Practitioner | 3731 Stocker St., Suite 105, Los Angeles, CA 90008 | 2019-01-16 |
| 1376055145 | Gentle F Carcamo | Rehabilitation Practitioner | 3731 Stoker Street, Ste. 105, Los Angeles, CA 90008 | 2017-11-01 |
| 1114445848 | Claudia Melgar | Rehabilitation Practitioner | 1540 Alcazar St # St133, Los Angeles, CA 90089-0080 | 2017-09-01 |
| 1134646516 | Maria Salas | Rehabilitation Practitioner | 333 S Beaudry Ave., Los Angeles, CA 90017 | 2017-08-25 |
| 1295257111 | Freddy Pablo | Rehabilitation Practitioner | 3580 Wilshire Blvd., Ste. 800, Los Angeles, CA 90010 | 2017-07-12 |
| 1356893796 | Rosemary Marroquin | Rehabilitation Practitioner | 511 N Harvard Blvd, Los Angeles, CA 90004-1906 | 2016-11-02 |
| 1902356520 | Aida Kimberly Escobar | Rehabilitation Practitioner | 2715 E 5th St, Los Angeles, CA 90033-4422 | 2016-10-06 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90062 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.