Stephanie Cheryl Rodriguez, RADT
Counselor, Addiction (Substance Use Disorder) in Fresno, CA. Individual provider (NPI-1).
NPI number1083177786
StatusActive
Last updated in NPPESFeb 12, 2020
Details
- NPI
- 1083177786
- Entity type
- Individual (NPI-1)
- Name
- Stephanie Cheryl Rodriguez
- Credential
- RADT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 9, 2019
- Certification date
- Feb 12, 2020
- Last updated
- Feb 12, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
2772 S Martin Luther King BlvdFresno, CA 93706
Phone 559-265-4800
Mailing address
2610 W Shaw Ln Ste 105Fresno, CA 93711-2775
Other practice locations
10535 Road 35
Madera, CA 93636-8487
Madera, CA 93636-8487
Phone 559-437-1144 · Fax 559-438-5004
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