Individual
PHYLLIS LOUISE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
496 S BARTON AVE, FRESNO, CA 93702-2985
(559) 374-3990
Mailing address
3420 WINTER WAY, MADERA, CA 93637-5956
(559) 275-3555
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 35583
CA
Other
Enumeration date
09/30/2014
Last updated
07/20/2023
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