Provider Demographics
NPI:1699103085
Name:LOERA, RODOLFO (LCSW)
Entity type:Individual
Prefix:MR
First Name:RODOLFO
Middle Name:
Last Name:LOERA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 S POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-4321
Mailing Address - Country:US
Mailing Address - Phone:714-376-9781
Mailing Address - Fax:
Practice Address - Street 1:1801 S POPLAR ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-4321
Practice Address - Country:US
Practice Address - Phone:714-376-9781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW881441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical