Healthcare Provider Details

I. General information

NPI: 1578885349
Provider Name (Legal Business Name): XOCHITL AMALIA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 05/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7839 BURGUNDY AVE
LAMONT CA
93241
US

IV. Provider business mailing address

PO BOX 78158
BAKERSFIELD CA
93383-8158
US

V. Phone/Fax

Practice location:
  • Phone: 661-845-5100
  • Fax: 661-845-5166
Mailing address:
  • Phone: 661-845-5100
  • Fax: 661-845-5166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: