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General NPI Number Information
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NPI Number | 1881457893
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Entity Type | Individual
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Provider Name | JACINDA DOMINIQUE RODRIGUEZ AMFT
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Gender | Female
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Dates
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Enumeration Date | 02/01/2024
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 2751 NAPA VALLEY CORPORATE DR BLDG B2ND
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City | NAPA
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State | CA
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Zip | 94558-6216
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Country | US
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Telephone | 831-710-1170
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Fax |
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Provider Business Mailing Address
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Address Line | 4151 AREZZO POINTE CT
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City | SAN JOSE
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State | CA
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Zip | 95148-4364
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Country | US
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Telephone | 831-710-1170
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 142183
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License Number State | CA
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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 | 142183
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License Number State | CA
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