Provider Demographics
NPI:1629108089
Name:RODRIGUEZ-JENSEN, TRINA MARIA
Entity Type:Individual
Prefix:MISS
First Name:TRINA
Middle Name:MARIA
Last Name:RODRIGUEZ-JENSEN
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 1:3845 N CLARK ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-4842
Mailing Address - Country:US
Mailing Address - Phone:559-216-2121
Mailing Address - Fax:559-457-1188
Practice Address - Street 1:3845 N CLARK ST STE 201
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-4842
Practice Address - Country:US
Practice Address - Phone:559-216-2121
Practice Address - Fax:559-457-1188
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA92502106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty