Healthcare Provider Details

I. General information

NPI: 1780756015
Provider Name (Legal Business Name): ESMERALDA C. RODRIGUEZ MSW, ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28050 ROAD 148 ROOM 14A
VISALIA CA
93292-9297
US

IV. Provider business mailing address

PO BOX 5091
VISALIA CA
93278-5091
US

V. Phone/Fax

Practice location:
  • Phone: 559-747-3984
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW 29329
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: