Healthcare Provider Details

I. General information

NPI: 1407791213
Provider Name (Legal Business Name): MARIA ANA CRUZ RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 IMPERIAL AVE
ROSAMOND CA
93560-7681
US

IV. Provider business mailing address

3844 W AVENUE J11
LANCASTER CA
93536-6349
US

V. Phone/Fax

Practice location:
  • Phone: 661-256-5030
  • Fax:
Mailing address:
  • Phone: 661-256-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number17730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: