Provider Demographics
NPI:1194131433
Name:RODRIGUEZ, VERONICA LARA (MA, BCBA)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:LARA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3138 N VENTURA RD
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-5360
Mailing Address - Country:US
Mailing Address - Phone:805-910-8330
Mailing Address - Fax:
Practice Address - Street 1:31344 VIA COLINAS STE 108
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-6797
Practice Address - Country:US
Practice Address - Phone:805-379-3212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-16711103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst