Provider Demographics
NPI:1326915943
Name:RODRIGUEZ, MELINDA JEAN
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:JEAN
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 1:1149 BARONA RD
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92040
Mailing Address - Country:US
Mailing Address - Phone:619-997-0091
Mailing Address - Fax:
Practice Address - Street 1:SUPERIOR TRANSPORT SERVICE
Practice Address - Street 2:1149 BARONA RD
Practice Address - City:LAKESIDE
Practice Address - State:CA
Practice Address - Zip Code:92040
Practice Address - Country:US
Practice Address - Phone:619-997-0091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)