Individual
GENA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
831 E ARROW HWY, POMONA, CA 91767-2535
(909) 398-4383
Mailing address
831 E ARROW HWY, POMONA, CA 91767-2535
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
—
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194473108
—
CA
Enumeration date
03/17/2022
Last updated
01/03/2025
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