Provider Demographics
NPI:1659137826
Name:RODRIGUEZ, SHARON ASTRID
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ASTRID
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 1:1079 HEBER AVE APT C
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-2744
Mailing Address - Country:US
Mailing Address - Phone:442-225-7522
Mailing Address - Fax:
Practice Address - Street 1:1079 HEBER AVE APT C
Practice Address - Street 2:
Practice Address - City:HEBER
Practice Address - State:CA
Practice Address - Zip Code:92249-9760
Practice Address - Country:US
Practice Address - Phone:442-225-7522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator