Provider Demographics
NPI:1457494122
Name:RODRIGUEZ, ARISVE (MSW)
Entity Type:Individual
Prefix:MS
First Name:ARISVE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:ARISVE
Other - Middle Name:
Other - Last Name:RODRIGUEZ-SOLARES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:340 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-3272
Mailing Address - Country:US
Mailing Address - Phone:408-307-0013
Mailing Address - Fax:408-259-0865
Practice Address - Street 1:828 S BASCOM AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2652
Practice Address - Country:US
Practice Address - Phone:408-307-0013
Practice Address - Fax:408-793-5955
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 271511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical