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General NPI Number Information
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NPI Number | 1831601145
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Entity Type | Individual
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Provider Name | CHANEL ELISE RODRIGUEZ FNP
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Gender | Female
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Dates
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Enumeration Date | 10/26/2017
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 110 SUTTER ST STE 600
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City | SAN FRANCISCO
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State | CA
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Zip | 94104-4020
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Country | US
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Telephone | 415-291-0480
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Fax | 415-252-7176
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Provider Business Mailing Address
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Address Line | 130 SUTTER ST FL 2
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City | SAN FRANCISCO
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State | CA
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Zip | 94104-4009
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Country | US
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Telephone | 415-347-8887
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95053133
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95006138
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License Number State | CA
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