Healthcare Provider Details

I. General information

NPI: 1245947829
Provider Name (Legal Business Name): GABRIELA ELIZABETH RODRIGUEZ PHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2022
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14530 SYLVAN ST
VAN NUYS CA
91411-2324
US

IV. Provider business mailing address

14924 HUBBARD ST
SYLMAR CA
91342-5426
US

V. Phone/Fax

Practice location:
  • Phone: 818-582-8839
  • Fax: 818-582-8836
Mailing address:
  • Phone: 818-675-8692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberRT1428260126
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number134268
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: