Provider Demographics
NPI:1073906095
Name:RODRIGUEZ, BEATRICE ALYCE
Entity Type:Individual
Prefix:MRS
First Name:BEATRICE
Middle Name:ALYCE
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 1:5810 RALSTON ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-5908
Mailing Address - Country:US
Mailing Address - Phone:805-642-7033
Mailing Address - Fax:
Practice Address - Street 1:5810 RALSTON ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-5908
Practice Address - Country:US
Practice Address - Phone:805-642-7033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-16
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health