Healthcare Provider Details

I. General information

NPI: 1396383899
Provider Name (Legal Business Name): FABIOLA RODRIGUEZ ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2019
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3688 E SHIELDS AVE
FRESNO CA
93726-6922
US

IV. Provider business mailing address

3688 E SHIELDS AVE
FRESNO CA
93726-6922
US

V. Phone/Fax

Practice location:
  • Phone: 559-600-0850
  • Fax:
Mailing address:
  • Phone: 559-600-9180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW122164
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: