Provider Demographics
NPI:1508035437
Name:RODRIGUEZ, BRENDA PATRICIA
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:PATRICIA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9150 EAST IMPERIAL HIGHWAY
Mailing Address - Street 2:ROOM P-31
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242
Mailing Address - Country:US
Mailing Address - Phone:562-940-3694
Mailing Address - Fax:562-658-4725
Practice Address - Street 1:14414 DELANO STREET
Practice Address - Street 2:ESFV
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401
Practice Address - Country:US
Practice Address - Phone:818-374-2000
Practice Address - Fax:818-374-2322
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist