Individual
MRS. JUANA ELVIRA RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12385 CREEKVIEW DR UNIT 121, SAN DIEGO, CA 92128-6642
(951) 533-6114
Mailing address
12385 CREEKVIEW DR UNIT 121, SAN DIEGO, CA 92128-6642
(951) 533-6114
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N7665991
DRIVER LICENSE
CA
Enumeration date
09/21/2019
Last updated
09/21/2019
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