Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor |
NPI | 1003301474 |
---|---|
Provider Name | Gabriela Rodriguez |
First Address | Hayward, CA 94544-3164 |
Second Address | Hayward, CA 94544-3164 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2018 |
Last Update Date | 27/06/2018 |