Provider Demographics
NPI:1285878108
Name:RODRIGUEZ, ROBERTA MICHELE
Entity type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:MICHELE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4451 CALIFORNIA AVE APT 30
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1171
Mailing Address - Country:US
Mailing Address - Phone:661-283-1375
Mailing Address - Fax:
Practice Address - Street 1:2901 S H ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-5602
Practice Address - Country:US
Practice Address - Phone:661-398-4303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)