Healthcare Provider Details

I. General information

NPI: 1467001750
Provider Name (Legal Business Name): KATHERINNE RODRIGUEZ B.A. IN SOCIOLOGY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 WASHBURN ST
SAN FRANCISCO CA
94103-2663
US

IV. Provider business mailing address

555 JOHN MUIR DR APT 418B
SAN FRANCISCO CA
94132-1049
US

V. Phone/Fax

Practice location:
  • Phone: 415-864-8701
  • Fax: 415-864-0682
Mailing address:
  • Phone: 408-420-2688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: