Healthcare Provider Details

I. General information

NPI: 1164249587
Provider Name (Legal Business Name): DEANNA LEANN RODRIGUEZ AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E BELLE TER
BAKERSFIELD CA
93307-3871
US

IV. Provider business mailing address

1600 E BELLE TER
BAKERSFIELD CA
93307-3871
US

V. Phone/Fax

Practice location:
  • Phone: 661-322-3908
  • Fax: 661-322-5003
Mailing address:
  • Phone: 661-322-3908
  • Fax: 661-322-5003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number21930
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number161613
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: