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General NPI Number Information
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NPI Number | 1679121768
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Entity Type | Individual
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Provider Name | SYLVIA LETICIA RODRIGUEZ-ADEDOJA NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 08/31/2019
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Last Update Date | 09/15/2021
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Provider Practice Location Address
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Address Line | 6608 MERCY CT STE B
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City | FAIR OAKS
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State | CA
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Zip | 95628-3171
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Country | US
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Telephone | 916-241-9844
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Fax |
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Provider Business Mailing Address
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Address Line | 5029 TROUVILLE LN
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City | SACRAMENTO
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State | CA
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Zip | 95835-2049
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Country | US
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Telephone | 919-273-6590
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 95012628
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License Number State | CA
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