MEDICARE: SONIA 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
1	373H00000X	Day Training/Habilitation Specialist
2	172V00000X	Community Health Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	E659659	OTHER	CA	COMMUNITY WORKER

General Provider Information

NPI Number	:	1265063747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA RODRIGUEZ

Provider Business Mailing Address
First Line	:	3751 STOCKER ST
Second Line	:
City	:	VIEW PARK
State	:	CA
Zip	:	90008-5101
Country	:	US
Telephone Number	:	323-298-3680
Fax Number	:

Provider Business Practice Location Address
First Line	:	3609 10TH AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-4114
Country	:	US
Telephone Number	:	323-298-3680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2020
Last Update Date	:	05/14/2025

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Directions to “ SONIA RODRIGUEZ ” Practice Location

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