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General NPI Number Information
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NPI Number | 1255241139
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Entity Type | Individual
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Provider Name | ELIZABETH VICTORIA RODRIGUEZ FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/11/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 1300 MABLE AVE STE 2
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City | MODESTO
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State | CA
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Zip | 95355-1120
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Country | US
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Telephone | 209-448-3000
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Fax | 209-442-4116
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Provider Business Mailing Address
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Address Line | 131 E. KERN AVE PMB 1024
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City | TULARE
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State | CA
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Zip | 93274
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Country | US
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Telephone | 209-681-3397
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95027909
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License Number State | CA
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