Healthcare Provider Details

I. General information

NPI: 1275261695
Provider Name (Legal Business Name): JOURNEYWORK PSYCHOTHERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 E COLORADO BLVD STE 205
PASADENA CA
91101-2028
US

IV. Provider business mailing address

PO BOX 91828
PASADENA CA
91109-1828
US

V. Phone/Fax

Practice location:
  • Phone: 626-760-1067
  • Fax: 626-602-3995
Mailing address:
  • Phone: 626-760-1067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE RODRIGUEZ
Title or Position: OWNER
Credential: LCSW
Phone: 626-760-1067