Provider Demographics
NPI:1760715031
Name:RODRIGUES, NATALIE DOMINIQUES
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:DOMINIQUES
Last Name:RODRIGUES
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 1:605 CHENERY ST.
Mailing Address - Street 2:SUITE C.
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131
Mailing Address - Country:US
Mailing Address - Phone:415-585-1990
Mailing Address - Fax:415-585-1990
Practice Address - Street 1:605 CHENERY ST.
Practice Address - Street 2:SUITE C.
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131
Practice Address - Country:US
Practice Address - Phone:415-585-1990
Practice Address - Fax:415-585-1990
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA001283225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist