Provider Demographics
NPI:1639534316
Name:RODRIGUEZ, JOSE ALBERTO (DNP, CRNA, APRN)
Entity Type:Individual
Prefix:DR
First Name:JOSE ALBERTO
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DNP, CRNA, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 S CRENSHAW ST APT A
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-8849
Mailing Address - Country:US
Mailing Address - Phone:203-589-9189
Mailing Address - Fax:
Practice Address - Street 1:115 MALL DR
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5786
Practice Address - Country:US
Practice Address - Phone:559-582-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-22
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95248512163W00000X
CT072732163W00000X
CT72732163WC0200X
CANA95001548207L00000X, 367500000X
CT6473363L00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner