Provider Demographics
NPI:1578265781
Name:RODRIGUEZ INIGUEZ, ARMANDO
Entity type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:RODRIGUEZ INIGUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11040 BOLLINGER CANYON RD # 155
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-4969
Mailing Address - Country:US
Mailing Address - Phone:925-915-0610
Mailing Address - Fax:
Practice Address - Street 1:120 ASCOT CT APT B
Practice Address - Street 2:
Practice Address - City:MORAGA
Practice Address - State:CA
Practice Address - Zip Code:94556-1437
Practice Address - Country:US
Practice Address - Phone:352-213-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician