Provider Demographics
NPI:1629798434
Name:RODRIGUEZ, TAYLOR ELIZABETH (MSW)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:ELIZABETH
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:ELIZABETH
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2890 INLAND EMPIRE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-4649
Mailing Address - Country:US
Mailing Address - Phone:909-233-7265
Mailing Address - Fax:
Practice Address - Street 1:2890 INLAND EMPIRE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-4649
Practice Address - Country:US
Practice Address - Phone:909-233-7265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1193361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical