Shasta Rodriguez is a Peer Specialist based in Medford, OR. Shasta Rodriguez practices in Medford, OR. The NPI Number for Shasta Rodriguez is 1386218386 and holds a License No. 104709 (Oregon).
The current practice location address for Shasta Rodriguez is 300 W Main St, Medford, OR and can be reached out via phone at 541-200-2407.
Location: 300 W Main St, Medford, OR, 97501-2756
Provider Profile Details
NPI Number
1386218386
Provider Name
Shasta Rodriguez
Credential
Provider Entity Type
Individual
Gender
Female
Address
300 W Main St, Medford, OR, 97501-2756
Phone Number
541-200-2407
Fax Number
Provider Enumeration Date
05/14/2021
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
300 W Main St
City
State
Zip
97501-2756
Phone Number
541-200-2407
Fax Number
Provider Business Mailing Address Details
Address
300 W Main St
City
State
Zip
97501-2756
Phone Number
541-200-2407
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
104709 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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