Healthcare Provider Details

I. General information

NPI: 1679092076
Provider Name (Legal Business Name): ANA LORENA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2017
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 S SOLANO DR
LAS CRUCES NM
88001-3758
US

IV. Provider business mailing address

200 DESERT PASS ST APT 121
EL PASO TX
79912-3665
US

V. Phone/Fax

Practice location:
  • Phone: 401-677-7342
  • Fax:
Mailing address:
  • Phone: 401-477-7342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2025-0933
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: