Provider Demographics
NPI:1497939342
Name:RODRIGUEZ, MARJORIE CONSUELO (MA)
Entity Type:Individual
Prefix:MRS
First Name:MARJORIE
Middle Name:CONSUELO
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4835 CLAIRE DR.
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057
Mailing Address - Country:US
Mailing Address - Phone:760-822-9966
Mailing Address - Fax:
Practice Address - Street 1:18945 FM 2252 FLEET 115
Practice Address - Street 2:
Practice Address - City:GARDENRIDGE
Practice Address - State:TX
Practice Address - Zip Code:78266
Practice Address - Country:US
Practice Address - Phone:210-651-0027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide