Healthcare Provider Details

I. General information

NPI: 1265992465
Provider Name (Legal Business Name): FABIOLA CONTRERAS RODRIGUEZ PSY.D, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 S STATE COLLEGE BLVD STE 100
ANAHEIM CA
92806-6136
US

IV. Provider business mailing address

9246 LIGHTWAVE AVE STE 120
SAN DIEGO CA
92123-6411
US

V. Phone/Fax

Practice location:
  • Phone: 800-270-5016
  • Fax: 800-680-3626
Mailing address:
  • Phone: 800-270-5016
  • Fax: 800-680-3626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT163527
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: