Healthcare Provider Details

I. General information

NPI: 1962313973
Provider Name (Legal Business Name): SIERRA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20512 1ST ST
COTTONWOOD CA
96022-8808
US

IV. Provider business mailing address

19206 SANDPIPER LN
COTTONWOOD CA
96022-7907
US

V. Phone/Fax

Practice location:
  • Phone: 530-347-3123
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41540
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: