Healthcare Provider Details

I. General information

NPI: 1427394626
Provider Name (Legal Business Name): EMILIO EDUARDO RODRIGUEZ M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: N/A N/A N/A MASTERS OF SCIENCE

II. Dates (important events)

Enumeration Date: 12/17/2012
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 S HUGHES AVE
FRESNO CA
93706-2321
US

IV. Provider business mailing address

2440 TULARE ST STE 200
FRESNO CA
93721-2281
US

V. Phone/Fax

Practice location:
  • Phone: 559-233-3454
  • Fax:
Mailing address:
  • Phone: 559-443-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9447
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9447
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: