MEDICARE: YVONNE GABRIELLA RODRIGUEZ MSW

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	29377	CA

General Provider Information

NPI Number	:	1639375777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVONNE GABRIELLA RODRIGUEZ MSW

Provider Business Mailing Address
First Line	:	2001 E 4TH ST STE 200
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-3916
Country	:	US
Telephone Number	:	562-708-4492
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 E 4TH ST STE 200
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-3916
Country	:	US
Telephone Number	:	714-824-8140
Fax Number	:

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	02/17/2022

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