Individual
CHANTEL RODRIGUEZ HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2772 S MARTIN L KING JR BLVD, FRESNO, CA 93706-5345
(559) 265-4818
Mailing address
541 RAMBLER RD, MERCED, CA 95348-3351
(209) 707-5077
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SUDR9888
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YA0400X
—
CA
01
—
SUDR9888
CADTP
CA
Enumeration date
08/18/2019
Last updated
06/01/2023
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