Healthcare Provider Details

I. General information

NPI: 1407764897
Provider Name (Legal Business Name): MATTHEW RODRIGUEZ LEGASPI AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31358 SANTA ELENA WAY
UNION CITY CA
94587-2846
US

IV. Provider business mailing address

31358 SANTA ELENA WAY
UNION CITY CA
94587-2846
US

V. Phone/Fax

Practice location:
  • Phone: 408-599-1779
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberAMFT153849
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: