Healthcare Provider Details

I. General information

NPI: 1831651017
Provider Name (Legal Business Name): KAREN C RODRIGUEZ LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2791
SANTA CLARA CA
95055-2791
US

IV. Provider business mailing address

6203 SAN IGNACIO AVE STE 150
SAN JOSE CA
95119-1371
US

V. Phone/Fax

Practice location:
  • Phone: 408-221-9977
  • Fax:
Mailing address:
  • Phone: 669-220-1905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT126546
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: