Healthcare Provider Details

I. General information

NPI: 1184114704
Provider Name (Legal Business Name): CLAUDIA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 N 4TH ST
SAN JOSE CA
95112-4713
US

IV. Provider business mailing address

248 DENNIS DR
DALY CITY CA
94015-2868
US

V. Phone/Fax

Practice location:
  • Phone: 800-906-0862
  • Fax:
Mailing address:
  • Phone: 650-520-6727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number94028719
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: