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Individual

DR. ALISA A RODA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
12140 NEW YORK RANCH RD, JACKSON RANCHERIA HEALTH COMPLEX, JACKSON, CA 95642-9407
(209) 257-2400
(209) 257-2403
Mailing address
10305 PROMENADE PKWY, ELK GROVE, CA 95757-9400
(916) 478-5000
(877) 738-4262

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G79164
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G791640
CA
Enumeration date
07/22/2005
Last updated
01/10/2022
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