Provider Demographics
NPI:1598306631
Name:RODRIGUEZ, ANA MARGARITA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:MARGARITA
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 1:262 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-1440
Mailing Address - Country:US
Mailing Address - Phone:909-640-5312
Mailing Address - Fax:
Practice Address - Street 1:1214 EDDINGTON ST
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3440
Practice Address - Country:US
Practice Address - Phone:909-931-1137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator