Basic Information
| Provider Information | |||||||||
| NPI: | 1194131433 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ | ||||||||
| FirstName: | VERONICA | ||||||||
| MiddleName: | LARA | ||||||||
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| Credential: | M.A., B.C.B.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3138 N VENTURA RD | ||||||||
| Address2: | |||||||||
| City: | OXNARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930365360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059108330 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 31344 VIA COLINAS STE 108 | ||||||||
| Address2: | |||||||||
| City: | WESTLAKE VILLAGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913626797 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053793212 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2014 | ||||||||
| LastUpdateDate: | 05/31/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-14-16711 | CA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.