MEDICARE: MRS. CAROLINA ROSARIO RODRIGUEZ LCSW

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	135986	CA

General Provider Information

NPI Number	:	1346050028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROLINA ROSARIO RODRIGUEZ LCSW

Provider Business Mailing Address
First Line	:	5173 AVENIDA DE LA PLATA
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92057-8023
Country	:	US
Telephone Number	:	310-720-7658
Fax Number	:

Provider Business Practice Location Address
First Line	:	5173 AVENIDA DE LA PLATA
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92057-8023
Country	:	US
Telephone Number	:	310-720-7658
Fax Number	:

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

Provider Enumeration Date	:	01/13/2025
Last Update Date	:	12/18/2025

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