Healthcare Provider Details

I. General information

NPI: 1861343220
Provider Name (Legal Business Name): ARBORIS MARRIAGE AND FAMILY THERAPY, PROFESSIONAL COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 SOUTHGATE AVE UNIT 3382
DALY CITY CA
94015-5303
US

IV. Provider business mailing address

199 SOUTHGATE AVE UNIT 3382
DALY CITY CA
94015-5303
US

V. Phone/Fax

Practice location:
  • Phone: 650-684-7699
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: NICOLE RODRIGUEZ
Title or Position: CEO/OWNER
Credential: LMFT #159223
Phone: 415-672-8147