Provider Demographics
NPI:1225288806
Name:RODRIGUEZ, ERICA DIANA (MS, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:DIANA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:DIANA
Other - Last Name:RUVALCABA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-A
Mailing Address - Street 1:7373 WEST LN
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-3377
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7373 WEST LN
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-3377
Practice Address - Country:US
Practice Address - Phone:209-476-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2580231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist