Healthcare Provider Details

I. General information

NPI: 1265378368
Provider Name (Legal Business Name): ROSA PRECIADO-RODRIGUEZ CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 GENEVA AVE
SAN FRANCISCO CA
94112-3848
US

IV. Provider business mailing address

346 CONMUR ST
SOUTH SAN FRANCISCO CA
94080-5647
US

V. Phone/Fax

Practice location:
  • Phone: 650-488-1728
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP10773
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: