Provider Demographics
NPI:1568526333
Name:RODRIQUEZ, LUIS SAUL (RN)
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:SAUL
Last Name:RODRIQUEZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15710 OAK DR
Mailing Address - Street 2:
Mailing Address - City:KERMAN
Mailing Address - State:CA
Mailing Address - Zip Code:93630-1243
Mailing Address - Country:US
Mailing Address - Phone:559-842-7185
Mailing Address - Fax:
Practice Address - Street 1:15710 OAK DR
Practice Address - Street 2:
Practice Address - City:KERMAN
Practice Address - State:CA
Practice Address - Zip Code:93630-1243
Practice Address - Country:US
Practice Address - Phone:559-842-7185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA308738163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health