Healthcare Provider Details

I. General information

NPI: 1376499723
Provider Name (Legal Business Name): KARLA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6557 1/2 S VICTORIA AVE
LOS ANGELES CA
90043-4309
US

IV. Provider business mailing address

6557 1/2 S VICTORIA AVE
LOS ANGELES CA
90043-4309
US

V. Phone/Fax

Practice location:
  • Phone: 323-599-2619
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: