Healthcare Provider Details

I. General information

NPI: 1760349567
Provider Name (Legal Business Name): ARACELY RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

642 W MAIN ST
MERCED CA
95340-4718
US

IV. Provider business mailing address

18383 ARROYA AVE
DOS PALOS CA
93620-9726
US

V. Phone/Fax

Practice location:
  • Phone: 209-205-1058
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number148025
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: