Provider Demographics
NPI:1639346646
Name:RODRIGUEZ, MARIA J (CARE MANAGER)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:J
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CARE MANAGER
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:J
Other - Last Name:MELGOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4545 N WEST AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93705-0946
Mailing Address - Country:US
Mailing Address - Phone:559-229-3561
Mailing Address - Fax:559-229-3581
Practice Address - Street 1:4545 N WEST AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93705-0946
Practice Address - Country:US
Practice Address - Phone:559-229-3561
Practice Address - Fax:559-229-3581
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No104100000XBehavioral Health & Social Service ProvidersSocial Worker