Provider Demographics
NPI:1831434083
Name:RODRIGUEZ, MONICA ADRIANA
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:ADRIANA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MONICA
Other - Middle Name:ADRIANA
Other - Last Name:VAZQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:15428 LONGWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-6268
Mailing Address - Country:US
Mailing Address - Phone:562-405-4290
Mailing Address - Fax:
Practice Address - Street 1:3200 MOTOR AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-3710
Practice Address - Country:US
Practice Address - Phone:310-836-1223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner