Healthcare Provider Details

I. General information

NPI: 1013846799
Provider Name (Legal Business Name): RACHELLE RODRIGUEZ M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36105 MURRIETA OAKS AVE
MURRIETA CA
92562-2311
US

IV. Provider business mailing address

32032 BAYWOOD ST
LAKE ELSINORE CA
92532-2529
US

V. Phone/Fax

Practice location:
  • Phone: 951-445-4110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number27810
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: