Healthcare Provider Details

I. General information

NPI: 1881167930
Provider Name (Legal Business Name): JOHN MOSES RODRIGUEZ NAVEJAS M.S., AMFT 105234
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOHN RODRIGUEZ NAVEJAS M.S., AMFT 105234

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 BAKER ST
BAKERSFIELD CA
93305-3061
US

IV. Provider business mailing address

2000 BAKER ST
BAKERSFIELD CA
93305-3061
US

V. Phone/Fax

Practice location:
  • Phone: 661-873-4927
  • Fax: 661-325-3929
Mailing address:
  • Phone: 661-903-3001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number105234
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number105234
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: