Provider Demographics
NPI:1508262742
Name:RODRIGUEZ, JOSHUA JOHN (PT, DPT, OCS)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JOHN
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1857 CORTE PULSERA
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-6554
Mailing Address - Country:US
Mailing Address - Phone:626-367-5215
Mailing Address - Fax:
Practice Address - Street 1:1338 MAIN ST
Practice Address - Street 2:
Practice Address - City:RAMONA
Practice Address - State:CA
Practice Address - Zip Code:92065
Practice Address - Country:US
Practice Address - Phone:760-789-1400
Practice Address - Fax:760-789-1401
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2018-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA418202251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic