Healthcare Provider Details

I. General information

NPI: 1811772304
Provider Name (Legal Business Name): ADRIANA RODRIGUEZ-REYES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 MISSION ST STE 100
SANTA CRUZ CA
95060-3747
US

IV. Provider business mailing address

133 MISSION ST STE 100
SANTA CRUZ CA
95060-3747
US

V. Phone/Fax

Practice location:
  • Phone: 831-429-3410
  • Fax:
Mailing address:
  • Phone: 831-427-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number118507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: