Provider Demographics
NPI:1154644813
Name:RODRIGUEZ, KAREN ANN (RN, MN, CPNP-PC/AC)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RN, MN, CPNP-PC/AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 W SUNSET BLVD # 100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6062
Mailing Address - Country:US
Mailing Address - Phone:323-361-5503
Mailing Address - Fax:323-361-3534
Practice Address - Street 1:4650 W SUNSET BLVD # 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-361-5503
Practice Address - Fax:323-361-3534
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA480512363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics