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NPI Code Detail

MEDICARE: JUAN RODRIGUEZ-MENDIAS BA

MEDICARE:   JUAN  RODRIGUEZ-MENDIAS  BA
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1649730870
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUAN RODRIGUEZ-MENDIAS BA
Provider Business Mailing Address
First Line : 8780 19TH ST UNIT 398
Second Line :
City : ALTA LOMA
State : CA
Zip : 91701-4608
Country : US
Telephone Number : 888-618-2327
Fax Number : 888-918-2327
Provider Business Practice Location Address
First Line : 527 E FAIRVIEW RD
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93307-5324
Country : US
Telephone Number : 888-618-2327
Fax Number : 888-918-2327
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2019
Last Update Date : 03/22/2019

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Directions to “ JUAN RODRIGUEZ-MENDIAS BA” Practice Location

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