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General NPI Number Information
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NPI Number | 1124957378
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Entity Type | Individual
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Provider Name | DERON DAVID RODRIGUEZ MS, CCC-SLP
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Gender | Male
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Dates
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Enumeration Date | 05/14/2026
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Last Update Date | 05/14/2026
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Provider Practice Location Address
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Address Line | 8000 AZTEC WAY
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City | ANTELOPE
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State | CA
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Zip | 95843-4486
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Country | US
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Telephone | 916-338-6470
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Fax | 916-338-6472
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Provider Business Mailing Address
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Address Line | PO BOX 269003
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City | SACRAMENTO
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State | CA
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Zip | 95826-9003
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Country | US
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Telephone | 916-709-5585
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Fax | 916-566-2057
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP12106
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License Number State | CA
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