Healthcare Provider Details

I. General information

NPI: 1346184728
Provider Name (Legal Business Name): GABRIELA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15350 RIVERVIEW RD
HELENDALE CA
92342
US

IV. Provider business mailing address

15350 RIVERVIEW RD
HELENDALE CA
92342
US

V. Phone/Fax

Practice location:
  • Phone: 760-952-1180
  • Fax:
Mailing address:
  • Phone: 760-952-1180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number240170476
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: