Provider Demographics
NPI:1932228525
Name:RODRIGUEZ, YOLANDA S
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:S
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 1:1702L MERIDIAN AVENUE
Mailing Address - Street 2:SUITE 178
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125
Mailing Address - Country:US
Mailing Address - Phone:408-625-9596
Mailing Address - Fax:
Practice Address - Street 1:375 WOODSIDE AVE
Practice Address - Street 2:BLDG W-3
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1221
Practice Address - Country:US
Practice Address - Phone:415-753-4446
Practice Address - Fax:415-753-7759
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW21310101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1959OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER
1959OtherSFGH INTERNAL USE ONLY