Provider Demographics
NPI:1194299214
Name:RODRIGUEZ, MARIA CAMILA (LMFT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CAMILA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 PASEO CT
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-5286
Mailing Address - Country:US
Mailing Address - Phone:646-675-1970
Mailing Address - Fax:
Practice Address - Street 1:150 PASEO CT
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-5286
Practice Address - Country:US
Practice Address - Phone:646-675-1970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110519106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist