Healthcare Provider Details

I. General information

NPI: 1578158853
Provider Name (Legal Business Name): NATALIE RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2021
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 K ST STE 150
SACRAMENTO CA
95816-5127
US

IV. Provider business mailing address

2715 K ST STE 150
SACRAMENTO CA
95816-5127
US

V. Phone/Fax

Practice location:
  • Phone: 916-510-8351
  • Fax: 916-415-3006
Mailing address:
  • Phone: 916-510-8351
  • Fax: 916-415-3006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP40475
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: