MEDICARE: STEPHANIE RODRIGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		CA

General Provider Information

NPI Number	:	1215864640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE RODRIGUEZ

Provider Business Mailing Address
First Line	:	310 S JEFFERSON ST APT 47D
Second Line	:
City	:	PLACENTIA
State	:	CA
Zip	:	92870-8477
Country	:	US
Telephone Number	:	714-834-5414
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 THE CITY DR S
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-3205
Country	:	US
Telephone Number	:	714-834-5414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

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Directions to “ STEPHANIE RODRIGUEZ ” Practice Location

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