Healthcare Provider Details

I. General information

NPI: 1265378301
Provider Name (Legal Business Name): HECTOR HUGO RODRIGUEZ RIVERA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27451 TOURNEY RD STE 120
VALENCIA CA
91355-6304
US

IV. Provider business mailing address

8601 VAN NUYS BLVD UNIT 1
PANORAMA CITY CA
91402
US

V. Phone/Fax

Practice location:
  • Phone: 818-208-1979
  • Fax:
Mailing address:
  • Phone: 818-818-9255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW131021
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: