Provider Demographics
NPI:1427298850
Name:RODRIGUEZ, MICHAEL TORRES I
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:TORRES
Last Name:RODRIGUEZ
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25863 S. JAYNE AVE.
Mailing Address - Street 2:
Mailing Address - City:COALINGA
Mailing Address - State:CA
Mailing Address - Zip Code:93210
Mailing Address - Country:US
Mailing Address - Phone:559-935-4900
Mailing Address - Fax:559-935-0519
Practice Address - Street 1:25863 JAYNE AVENUE
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210
Practice Address - Country:US
Practice Address - Phone:559-935-4900
Practice Address - Fax:559-935-0519
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)