=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790554814
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANGELA RODRIGUES
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/29/2023
-----------------------------------------------------
Last Update Date | 12/29/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3491 CAHUENGA BLVD W UNIT A
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90068-1338
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-431-1118
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 60 WILLIAMS ST
-----------------------------------------------------
City | INDEPENDENCE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97351-2221
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-572-3072
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374J00000X
-----------------------------------------------------
Taxonomy Name | Doula
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------