Basic Information
| Provider Information | |||||||||
| NPI: | 1295189603 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RODARTE | ||||||||
| FirstName: | CEASAR | ||||||||
| MiddleName: | AMADOR | ||||||||
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| Credential: | CAODC-CS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3230 WARING CT STE A | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920564509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603057528 | ||||||||
| FaxNumber: | 7605094410 | ||||||||
| Practice Location | |||||||||
| Address1: | 1560 CAPALINA RD | ||||||||
| Address2: | |||||||||
| City: | SAN MARCOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920691288 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607442104 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2016 | ||||||||
| LastUpdateDate: | 03/07/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | CADTP1602 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.