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General NPI Number Information
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NPI Number | 1003839176
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Entity Type | Individual
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Provider Name | DANA M. RODRIGUEZ N.P., PHD
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 4725 MARKET ST
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City | SAN DIEGO
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State | CA
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Zip | 92102-4715
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Country | US
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Telephone | 619-515-2560
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Fax |
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Provider Business Mailing Address
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Address Line | 823 GATEWAY CENTER WAY
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City | SAN DIEGO
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State | CA
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Zip | 92102-4541
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Country | US
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Telephone | 619-515-2300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 148732
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP8704
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 95027907
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License Number State | CA
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