MEDICARE: MR. RONALD ALFREDO 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
1	101YM0800X	Mental Health Counselor		CA

General Provider Information

NPI Number	:	1780543595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RONALD ALFREDO RODRIGUEZ

Provider Business Mailing Address
First Line	:	2601 CENTER AVE APT 104
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94804-3060
Country	:	US
Telephone Number	:	408-778-5120
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 CENTER AVE APT 104
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94804-3060
Country	:	US
Telephone Number	:	408-778-5120
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2026
Last Update Date	:	01/17/2026

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Directions to “ MR. RONALD ALFREDO RODRIGUEZ ” Practice Location

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