Provider Demographics
NPI:1205159969
Name:RODRIGUEZ, GUADALUPE G
Entity type:Individual
Prefix:MS
First Name:GUADALUPE
Middle Name:G
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 W JONES ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-5605
Mailing Address - Country:US
Mailing Address - Phone:820-300-8364
Mailing Address - Fax:
Practice Address - Street 1:112 W JONES ST STE 1
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-5605
Practice Address - Country:US
Practice Address - Phone:820-300-8364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health