Provider Demographics
NPI:1528399185
Name:RODRIGUEZ, SANDRA PAOLA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:PAOLA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27471 CABEZA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-1036
Mailing Address - Country:US
Mailing Address - Phone:949-290-1131
Mailing Address - Fax:
Practice Address - Street 1:27471 CABEZA
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-1036
Practice Address - Country:US
Practice Address - Phone:949-290-1131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30404225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist