Provider Demographics
NPI:1891957247
Name:GARZA, RODOLFO L (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RODOLFO
Middle Name:L
Last Name:GARZA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E ALMOND AVE STE 2B
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5600
Mailing Address - Country:US
Mailing Address - Phone:559-661-7574
Mailing Address - Fax:559-661-4874
Practice Address - Street 1:500 E ALMOND AVE STE 2B
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5600
Practice Address - Country:US
Practice Address - Phone:559-661-7574
Practice Address - Fax:559-661-4874
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS112991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ340212OtherPROVIDER