Provider Demographics
NPI:1770461352
Name:RODRIGUEZ, KARINA M (PPSP)
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:M
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PPSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31831 SKY BLUE WATER TRL
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-2768
Mailing Address - Country:US
Mailing Address - Phone:760-641-0005
Mailing Address - Fax:
Practice Address - Street 1:150 DISTRICT CENTER DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-3626
Practice Address - Country:US
Practice Address - Phone:760-883-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240173134103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist