Provider Demographics
NPI:1023299898
Name:RODRIGUEZ MASON, CARIDAD (LMFT)
Entity type:Individual
Prefix:
First Name:CARIDAD
Middle Name:
Last Name:RODRIGUEZ MASON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 POLLASKY AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-2654
Mailing Address - Country:US
Mailing Address - Phone:559-623-0929
Mailing Address - Fax:559-321-8582
Practice Address - Street 1:1629 POLLASKY AVE STE 106
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-2654
Practice Address - Country:US
Practice Address - Phone:559-623-0929
Practice Address - Fax:559-321-8582
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41636101YM0800X, 106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health