Individual ProviderAgustin RodriguezCounselorBehavioral Health & Social Service ProvidersPractice Address1126 W Foothill Blvd Ste 110, Upland, CA 91786-3786(909) 985-0513PECOS EnrollmentBased on the most recent information from CMS, provider Agustin Rodriguez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1043991557Provider TypeIndividualFull NameRodriguez, AgustinTitleMr.CredentialLMFT 122485GenderMaleSole ProprietorNoEnumeration Date7/27/2023Last Updated7/27/2023Contact InformationPractice LocationPractice Address1126 W Foothill Blvd Ste 110, Upland, CA 91786-3786Phone(909) 985-0513Fax(909) 985-7193Mailing LocationMailing Address1126 W Foothill Blvd Ste 110, Upland, CA 91786-3786Phone(909) 985-0513Fax(909) 985-7193Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense122485California