Provider Demographics
NPI:1356334320
Name:RODRIGUEZ, JOYCE M (PHD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:M
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 29TH ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3522
Mailing Address - Country:US
Mailing Address - Phone:510-832-4056
Mailing Address - Fax:510-832-8507
Practice Address - Street 1:400 29TH ST
Practice Address - Street 2:SUITE 304
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3522
Practice Address - Country:US
Practice Address - Phone:510-832-4056
Practice Address - Fax:510-832-8507
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU590231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0005902Medicaid
CAAU590OtherAUDIOLOGY
CAHA1362OtherHEARING AID LICENSE
CAHA1362OtherHEARING AID LICENSE