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NPI Code Detail

MEDICARE: LAURA ELLEN RODRIGUEZ

MEDICARE:   LAURA ELLEN 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
1106H00000XMarriage & Family TherapistLMFT38042CA

General Provider Information

NPI Number : 1396801379
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA ELLEN RODRIGUEZ
Provider Business Mailing Address
First Line : 1930 MARKET ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94102-6228
Country : US
Telephone Number : 415-476-3902
Fax Number : 415-255-2101
Provider Business Practice Location Address
First Line : 1930 MARKET ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94102-6228
Country : US
Telephone Number : 415-476-3902
Fax Number : 415-255-2101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2006
Last Update Date : 06/21/2024

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Directions to “ LAURA ELLEN RODRIGUEZ ” Practice Location

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