Healthcare Provider Details

I. General information

NPI: 1740197391
Provider Name (Legal Business Name): JANIKA BOGUSZEWSKI RODRIGUEZ ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANIKA RODRIGUEZ ASW

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260B 45TH ST
EMERYVILLE CA
94608-2907
US

IV. Provider business mailing address

PO BOX 26
MILL VALLEY CA
94942-0026
US

V. Phone/Fax

Practice location:
  • Phone: 510-345-1474
  • Fax:
Mailing address:
  • Phone: 209-484-5724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW138288
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: