Provider Demographics
NPI:1407286719
Name:RODRIGUEZ, MARIBEL
Entity Type:Individual
Prefix:MRS
First Name:MARIBEL
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARIBEL
Other - Middle Name:
Other - Last Name:ROSAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3601 CALLE TECATE STE 201
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5056
Mailing Address - Country:US
Mailing Address - Phone:805-289-0120
Mailing Address - Fax:
Practice Address - Street 1:3601 CALLE TECATE STE 201
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-5056
Practice Address - Country:US
Practice Address - Phone:805-289-0120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist