Provider Demographics
NPI:1679051379
Name:WATSON, RHODA (MA)
Entity type:Individual
Prefix:
First Name:RHODA
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 TONO LN
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2045
Mailing Address - Country:US
Mailing Address - Phone:925-708-2134
Mailing Address - Fax:
Practice Address - Street 1:140 MAYHEW WAY STE 606
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4337
Practice Address - Country:US
Practice Address - Phone:925-932-0150
Practice Address - Fax:925-210-0842
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health