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General NPI Number Information
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NPI Number | 1376834614
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Entity Type | Individual
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Provider Name | SHAWNA RAE-ANN RODRIGUEZ PSY.D
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Gender | Female
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Dates
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Enumeration Date | 04/20/2011
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 1145 STURGIS RD
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City | TWENTYNINE PALMS
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State | CA
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Zip | 92278
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Country | US
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Telephone | 760-830-2190
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Fax |
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Provider Business Mailing Address
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Address Line | 33355 FOX RD
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City | TEMECULA
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State | CA
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Zip | 92592-4348
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Country | US
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Telephone | 619-985-1436
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0810006364
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License Number State | VA
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