Provider Demographics
NPI:1073870820
Name:RODRIGUEZ, DANIEL ANTHONY SR (AOD COUNSELOR)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ANTHONY
Last Name:RODRIGUEZ
Suffix:SR
Gender:M
Credentials:AOD COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33526 4TH ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-2413
Mailing Address - Country:US
Mailing Address - Phone:925-597-1575
Mailing Address - Fax:
Practice Address - Street 1:795 FLETCHER LN
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-1008
Practice Address - Country:US
Practice Address - Phone:510-247-8300
Practice Address - Fax:510-247-8295
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR0412281420101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)