Healthcare Provider Details

I. General information

NPI: 1861577819
Provider Name (Legal Business Name): ADRIAN RODRIGUEZ LCSW60626
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 06/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1965 LIVE OAK BLVD
YUBA CITY CA
95991-8850
US

IV. Provider business mailing address

1799 ESPLANADE WAY N/A
YUBA CITY CA
95993-1011
US

V. Phone/Fax

Practice location:
  • Phone: 530-822-7200
  • Fax: 530-822-7108
Mailing address:
  • Phone: 530-671-0943
  • Fax: 530-671-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW60626
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: