Provider Demographics
NPI:1144721614
Name:RODRIGUEZ, AUDRIANNA (BA)
Entity type:Individual
Prefix:
First Name:AUDRIANNA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 KAMAR ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-4047
Mailing Address - Country:US
Mailing Address - Phone:661-699-9043
Mailing Address - Fax:
Practice Address - Street 1:2309 KAMAR ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-4047
Practice Address - Country:US
Practice Address - Phone:661-699-9043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician