Healthcare Provider Details

I. General information

NPI: 1255471637
Provider Name (Legal Business Name): MARIBEL RODRIGUEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28125 BRADLEY RD STE 220
SUN CITY CA
92586-2288
US

IV. Provider business mailing address

28125 BRADLEY RD STE 220
SUN CITY CA
92586-2288
US

V. Phone/Fax

Practice location:
  • Phone: 909-421-9321
  • Fax: 909-421-9219
Mailing address:
  • Phone: 951-309-2140
  • Fax: 951-309-2141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW29495
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: