Provider Demographics
NPI:1700013273
Name:RODRIGUEZ, EVETTE
Entity Type:Individual
Prefix:
First Name:EVETTE
Middle Name:
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 1:1001 TOWER WAY STE 110
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1586
Mailing Address - Country:US
Mailing Address - Phone:661-859-2135
Mailing Address - Fax:661-323-1302
Practice Address - Street 1:1001 TOWER WAY STE 110
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1586
Practice Address - Country:US
Practice Address - Phone:661-859-2135
Practice Address - Fax:661-323-1302
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator