Healthcare Provider Details

I. General information

NPI: 1003534827
Provider Name (Legal Business Name): GABRIELA RODRIGUEZ RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4892 SAN PABLO DAM RD
EL SOBRANTE CA
94803-3222
US

IV. Provider business mailing address

4892 SAN PABLO DAM RD
EL SOBRANTE CA
94803-3222
US

V. Phone/Fax

Practice location:
  • Phone: 510-222-3946
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164050
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: