Provider Demographics
NPI:1982079257
Name:RODRIGUEZ, ELIZABETH BRAVO
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:BRAVO
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 1:2115 CENTERPOINTE PKWY STE 206
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-1334
Mailing Address - Country:US
Mailing Address - Phone:805-346-8435
Mailing Address - Fax:805-346-8279
Practice Address - Street 1:2115 CENTERPOINTE PKWY STE 206
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1334
Practice Address - Country:US
Practice Address - Phone:805-346-8435
Practice Address - Fax:805-346-8279
Is Sole Proprietor?:No
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide