Healthcare Provider Details

I. General information

NPI: 1144768565
Provider Name (Legal Business Name): GABRIELLE RODRIGUEZ RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2017
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 W PUTNAM AVE
PORTERVILLE CA
93257-3257
US

IV. Provider business mailing address

590 W PUTNAM AVE
PORTERVILLE CA
93257-3257
US

V. Phone/Fax

Practice location:
  • Phone: 951-204-4082
  • Fax:
Mailing address:
  • Phone: 559-781-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2372334
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95034038
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95387739
License Number StateCA
# 4
Primary TaxonomyN
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: