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General NPI Number Information
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NPI Number | 1437881489
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Entity Type | Individual
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Provider Name | CANDICE DANIELLA CATALEN RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 1650 E OLD BADILLO ST # B3
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City | COVINA
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State | CA
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Zip | 91724-3163
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Country | US
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Telephone | 626-251-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 517 S NEWHOPE ST APT 21
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City | SANTA ANA
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State | CA
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Zip | 92704-2186
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Country | US
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Telephone | 714-300-3143
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW90354
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License Number State | CA
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