MEDICARE: JENNIFER L RODRIGUEZ PT

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	225100000X	Physical Therapist	10088	AZ
2	225100000X	Physical Therapist	PT39553	CA

General Provider Information

NPI Number	:	1437494721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER L RODRIGUEZ PT

Provider Business Mailing Address
First Line	:	4055 OCEANSIDE BLVD STE F
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-5821
Country	:	US
Telephone Number	:	760-842-7519
Fax Number	:	760-657-2994

Provider Business Practice Location Address
First Line	:	4055 OCEANSIDE BLVD
Second Line	:	STE C
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-5821
Country	:	US
Telephone Number	:	760-586-2728
Fax Number	:

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

Provider Enumeration Date	:	11/28/2012
Last Update Date	:	07/19/2024

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