Provider Demographics
NPI:1881915361
Name:RODRIGUEZ, JULES ARIEL (DC)
Entity type:Individual
Prefix:
First Name:JULES
Middle Name:ARIEL
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 SEABRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062
Mailing Address - Country:US
Mailing Address - Phone:831-425-1422
Mailing Address - Fax:831-425-1444
Practice Address - Street 1:1709 SEABRIGHT AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2118
Practice Address - Country:US
Practice Address - Phone:831-425-1422
Practice Address - Fax:831-425-1444
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29989111N00000X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist