Rodriguez, Jose Antonio

Rodriguez, Jose Antonio is an sole proprietor health care provider with primary practice located at 12625 Heacock St , Moreno Valley CA 92553-0538. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Rodriguez, Jose Antonio can be contacted via phone (951) 486-7948.

Contact Information

Primary practice address
12625 Heacock St Moreno Valley CA 92553-0538
Phone: (951) 486-7948
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 72189 California
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW94079 California

Profile Details

NPI number 1033585021
LBN Legal business name Rodriguez, Jose Antonio
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 13th, 2015
Last updated May 18th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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