Provider Demographics
NPI:1649769555
Name:RODRIGUEZ, JULIETA (MD, MPH)
Entity Type:Individual
Prefix:
First Name:JULIETA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:JULIETTA
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:500 PARNASSUS AVE., MU250 EAST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0474
Mailing Address - Country:US
Mailing Address - Phone:415-476-4562
Mailing Address - Fax:
Practice Address - Street 1:500 PARNASSUS AVE., MU250 EAST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143
Practice Address - Country:US
Practice Address - Phone:415-476-4562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA176776207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program