Healthcare Provider Details

I. General information

NPI: 1457026684
Provider Name (Legal Business Name): ALEXIS RODRIGUEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR
OXNARD CA
93036-2612
US

IV. Provider business mailing address

115 S LA CUMBRE LN STE 200
SANTA BARBARA CA
93105-5104
US

V. Phone/Fax

Practice location:
  • Phone: 866-998-2243
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberACSW109671
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number130391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: