Individual
JESSICA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
414 E SAN BERNARDINO RD, COVINA, CA 91723-1704
(626) 367-3206
Mailing address
2196 N VALLEJO WAY, UPLAND, CA 91784-1438
(909) 532-9086
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
2355S0801X
Speech-Language Assistant
6474
CA
2355S0801X
Speech-Language Assistant
Primary
6474
—
Other
Enumeration date
08/01/2019
Last updated
09/15/2024
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