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NPI Code Detail

MEDICARE: DESIREE RODRIGUEZ

MEDICARE: DESIREE RODRIGUEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1003557174
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESIREE RODRIGUEZ
Provider Business Mailing Address
First Line : 2029 KEITH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-3128
Country : US
Telephone Number : 213-721-0010
Fax Number :
Provider Business Practice Location Address
First Line : 2029 KEITH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-3128
Country : US
Telephone Number : 213-721-0010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2022
Last Update Date : 05/22/2025

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Directions to “ DESIREE RODRIGUEZ ” Practice Location

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