Healthcare Provider Details

I. General information

NPI: 1801522487
Provider Name (Legal Business Name): EUGENIA RODRIGUEZ PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 4TH ST
SAN FRANCISCO CA
94143-2350
US

IV. Provider business mailing address

244 LITTLETON ST
OAKLEY CA
94561-2630
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-9600
  • Fax: 415-353-7657
Mailing address:
  • Phone: 510-541-6184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA61969
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: