Provider Demographics
NPI:1710502075
Name:RODRIGUEZ, ROSA LINDA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:LINDA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 GROSSMONT CENTER DR STE 440-2821
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3016
Mailing Address - Country:US
Mailing Address - Phone:619-894-6261
Mailing Address - Fax:
Practice Address - Street 1:8765 AERO DR STE 228
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1785
Practice Address - Country:US
Practice Address - Phone:619-894-6261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health