Healthcare Provider Details

I. General information

NPI: 1003657685
Provider Name (Legal Business Name): DESIREE ROCHELLE RODRIGUEZ NP, BSN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DESIREE ROCHELLE MONTIEL

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10230 ARTESIA BLVD
BELLFLOWER CA
90706-6763
US

IV. Provider business mailing address

15750 RYON AVE
BELLFLOWER CA
90706-3629
US

V. Phone/Fax

Practice location:
  • Phone: 562-270-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95028101
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: