Provider Demographics
NPI:1821337452
Name:RODRIGUEZ, MARIA LAURA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:LAURA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S COMMONWEALTH AVE FL 6
Mailing Address - Street 2:ATTENTION DMH
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-4016
Mailing Address - Country:US
Mailing Address - Phone:213-739-5505
Mailing Address - Fax:
Practice Address - Street 1:600 S COMMONWEALTH AVE FL 6
Practice Address - Street 2:ATTENTION DMH
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-4016
Practice Address - Country:US
Practice Address - Phone:213-739-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA273381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical