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General NPI Number Information
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NPI Number | 1972103398
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Entity Type | Individual
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Provider Name | VERA MAE RODRIGUEZ LMFT NO. 134497
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Gender | Female
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Dates
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Enumeration Date | 10/26/2020
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 5827 PINE AVE STE B
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City | CHINO HILLS
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State | CA
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Zip | 91709-6534
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Country | US
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Telephone | 949-939-0640
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 81014
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-8114
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Country | US
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Telephone | 949-939-0640
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 120027
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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 | 134497
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License Number State | CA
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