Provider Demographics
NPI:1982255154
Name:RODRIGUEZ, YVONNE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3665 E 1ST ST UNIT 410
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-2725
Mailing Address - Country:US
Mailing Address - Phone:562-480-1434
Mailing Address - Fax:
Practice Address - Street 1:4050 KATELLA AVE STE 206
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3479
Practice Address - Country:US
Practice Address - Phone:424-272-6268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-27
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139578106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist