Healthcare Provider Details

I. General information

NPI: 1558291492
Provider Name (Legal Business Name): ANA ANTONIO RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10533 WASHINGTON WAY
NORTHGLENN CO
80233-4131
US

IV. Provider business mailing address

10533 WASHINGTON WAY
NORTHGLENN CO
80233-4131
US

V. Phone/Fax

Practice location:
  • Phone: 720-526-4527
  • Fax:
Mailing address:
  • Phone: 720-526-4527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09932393
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: