Provider Demographics
NPI:1972239713
Name:RODRIGUES, JOHN RALPH
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:RALPH
Last Name:RODRIGUES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14605 COLTER WAY
Mailing Address - Street 2:
Mailing Address - City:MAGALIA
Mailing Address - State:CA
Mailing Address - Zip Code:95954-9632
Mailing Address - Country:US
Mailing Address - Phone:530-762-9015
Mailing Address - Fax:
Practice Address - Street 1:556 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2212
Practice Address - Country:US
Practice Address - Phone:530-762-9015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health