Provider Demographics
NPI:1215375134
Name:RODRIGUEZ, MARIA LUISA (LCSW82307)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LUISA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LCSW82307
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:LUISA
Other - Last Name:DENIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW82307
Mailing Address - Street 1:47825 OASIS ST
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-6950
Mailing Address - Country:US
Mailing Address - Phone:760-863-8455
Mailing Address - Fax:
Practice Address - Street 1:47825 OASIS ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-6950
Practice Address - Country:US
Practice Address - Phone:760-863-8455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CALCSW823071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health