Individual
JACQUELINE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
85 RAMONA EXPY, PERRIS, CA 92571-7014
(951) 509-2499
Mailing address
85 RAMONA EXPY, PERRIS, CA 92571-7014
(951) 509-2499
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
723976
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
723976
BVNPT
CA
Enumeration date
09/05/2022
Last updated
09/05/2022
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