Healthcare Provider Details

I. General information

NPI: 1669500377
Provider Name (Legal Business Name): ERIKA D. RODRIGUEZ ADM. ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 08/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 VALENCIA STREET MISSION COUNCIL
SAN FRANCISCO CA
94110
US

IV. Provider business mailing address

761 CAPP ST APT. 2
SAN FRANCISCO CA
94110-3202
US

V. Phone/Fax

Practice location:
  • Phone: 415-826-6767
  • Fax: 415-826-6774
Mailing address:
  • Phone: 510-672-5067
  • Fax: 415-826-6774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: