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NPI Code Detail

MEDICARE: ALIZE HENNESEY RODRIGUEZ

MEDICARE: ALIZE HENNESEY RODRIGUEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1255299970
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALIZE HENNESEY RODRIGUEZ
Provider Business Mailing Address
First Line : 99 PASADENA AVE STE 10C
Second Line :
City : SOUTH PASADENA
State : CA
Zip : 91030-6142
Country : US
Telephone Number : 323-404-1026
Fax Number : 213-607-4352
Provider Business Practice Location Address
First Line : 99 PASADENA AVE STE 10C
Second Line :
City : SOUTH PASADENA
State : CA
Zip : 91030-6142
Country : US
Telephone Number : 323-404-1026
Fax Number : 213-607-4352
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/12/2026

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Directions to “ ALIZE HENNESEY RODRIGUEZ ” Practice Location

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