Provider Demographics
NPI:1710042791
Name:RODRIGUEZ, DAWN MICHELLE (MFT)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELLE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7273 MURRAY DR
Mailing Address - Street 2:SUITE 16
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-3351
Mailing Address - Country:US
Mailing Address - Phone:209-688-3529
Mailing Address - Fax:209-644-6924
Practice Address - Street 1:7273 MURRAY DR
Practice Address - Street 2:SUITE 16
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-3351
Practice Address - Country:US
Practice Address - Phone:209-688-3529
Practice Address - Fax:209-644-6924
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health