Healthcare Provider Details

I. General information

NPI: 1164344677
Provider Name (Legal Business Name): REBECCA EMMA RODRIGUES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 E PLACITA LEZNA
SAHUARITA AZ
85629-8614
US

IV. Provider business mailing address

396 E PLACITA LEZNA
SAHUARITA AZ
85629-8614
US

V. Phone/Fax

Practice location:
  • Phone: 520-248-2911
  • Fax:
Mailing address:
  • Phone: 520-248-2911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberD09123398
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: