Individual
ALICIA IBETH RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 N 8TH ST, EL CENTRO, CA 92243-2302
(442) 265-1525
(442) 265-1638
Mailing address
202 N 8TH ST, EL CENTRO, CA 92243-2302
(442) 265-1525
(442) 265-1638
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
953069805
—
CA
Enumeration date
07/19/2016
Last updated
10/10/2016
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