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General NPI Number Information
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NPI Number | 1295031268
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Entity Type | Individual
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Provider Name | FERNANDO RODRIGUEZ
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Gender | Male
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Dates
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Enumeration Date | 02/08/2011
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 23701 E EAST FORK RD
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City | AZUSA
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State | CA
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Zip | 91702-1477
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Country | US
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Telephone | 626-250-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 1940 FULLERTON RD APT 84
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-3337
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Country | US
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Telephone | 626-391-2264
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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