Provider Demographics
NPI:1427307867
Name:RODRIGUEZ, BENJAMIN L (MA, BCBA)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:L
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2127 W ORANGEWOOD AVE
Mailing Address - Street 2:#B
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-1954
Mailing Address - Country:US
Mailing Address - Phone:714-634-8500
Mailing Address - Fax:800-832-2321
Practice Address - Street 1:2127 W ORANGEWOOD AVE
Practice Address - Street 2:B
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-1954
Practice Address - Country:US
Practice Address - Phone:714-634-8500
Practice Address - Fax:800-832-2321
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst