Provider Demographics
NPI:1528835154
Name:ROCIO B RODRIGUEZ LMFT DYNAMIC HEALTH AND HEALING
Entity type:Organization
Organization Name:ROCIO B RODRIGUEZ LMFT DYNAMIC HEALTH AND HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROCIO
Authorized Official - Middle Name:B
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:415-939-9005
Mailing Address - Street 1:1601 OLD BAYSHORE HWY STE 123
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-1506
Mailing Address - Country:US
Mailing Address - Phone:415-939-9005
Mailing Address - Fax:415-642-5477
Practice Address - Street 1:1601 OLD BAYSHORE HWY STE 123
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-1506
Practice Address - Country:US
Practice Address - Phone:415-939-9005
Practice Address - Fax:415-642-5477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health