MEDICARE: MARIA CRISTINA RODRIGUEZ MS, LMFT

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	101YM0800X	Mental Health Counselor	120808	CA
2	101YM0800X	Mental Health Counselor	142598	CA

General Provider Information

NPI Number	:	1780340620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA CRISTINA RODRIGUEZ MS, LMFT

Provider Business Mailing Address
First Line	:	1144 E 1ST ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-5618
Country	:	US
Telephone Number	:	650-534-5436
Fax Number	:

Provider Business Practice Location Address
First Line	:	1144 E 1ST ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-5618
Country	:	US
Telephone Number	:	650-534-5436
Fax Number	:

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

Provider Enumeration Date	:	11/15/2021
Last Update Date	:	11/14/2023

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