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NPI Code Detail

MEDICARE: MISS BETHANY ELIZABETH RODRIGUEZ REGISTERED DIETITIAN

MEDICARE: MISS BETHANY ELIZABETH RODRIGUEZ REGISTERED DIETITIAN
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
1133V00000XRegistered Dietitian1086112CA

General Provider Information

NPI Number : 1316303738
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS BETHANY ELIZABETH RODRIGUEZ REGISTERED DIETITIAN
Provider Business Mailing Address
First Line : 7283 W RIALTO AVE
Second Line :
City : FRESNO
State : CA
Zip : 93723-9407
Country : US
Telephone Number : 559-313-5721
Fax Number :
Provider Business Practice Location Address
First Line : 8525 N CEDAR AVE STE 109
Second Line :
City : FRESNO
State : CA
Zip : 93720-4833
Country : US
Telephone Number : 559-433-1120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2016
Last Update Date : 01/14/2016

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Directions to “ MISS BETHANY ELIZABETH RODRIGUEZ REGISTERED DIETITIAN” Practice Location

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