Healthcare Provider Details

I. General information

NPI: 1093178261
Provider Name (Legal Business Name): PAMELA JOY RODRIGUEZ ABAO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAMELA JOY ROSAS RODRIGUEZ

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27201 TOURNEY RD STE 200D
VALENCIA CA
91355-1855
US

IV. Provider business mailing address

601 E PALOMAR ST. STE C #676
CHULA VISTA CA
91911
US

V. Phone/Fax

Practice location:
  • Phone: 310-779-4920
  • Fax:
Mailing address:
  • Phone: 858-357-8950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95029526
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number794784
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: