Individual
IZELL MARIE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
16123 WASHINGTON ST, RIVERSIDE, CA 92504-5954
(951) 556-9703
Mailing address
16123 WASHINGTON ST, RIVERSIDE, CA 92504-5954
(951) 556-9703
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86007564
CA
Other
Enumeration date
10/12/2021
Last updated
10/12/2021
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