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General NPI Number Information
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NPI Number | 1659982429
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Entity Type | Individual
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Provider Name | KARLA YANINA RODAS
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Gender | Female
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 08/01/2023
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Provider Practice Location Address
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Address Line | 16152 BEACH BLVD STE 170
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3818
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Country | US
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Telephone | 213-290-5483
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3533
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City | EL SEGUNDO
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State | CA
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Zip | 90245-8593
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Country | US
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Telephone |
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 119696
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License Number State | CA
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