MEDICARE: MS. CHRISTINA M RODRIGUEZ ACSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	113925	CA

General Provider Information

NPI Number	:	1235818345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINA M RODRIGUEZ ACSW

Provider Business Mailing Address
First Line	:	27612 ENNISMORE AVE
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91351-3413
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 S BEAUDRY AVE FL 24
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-5107
Country	:	US
Telephone Number	:	818-280-9873
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2023
Last Update Date	:	07/17/2023

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