MEDICARE: ALEJANDRA 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	133N00000X	Nutritionist

General Provider Information

NPI Number	:	1356038939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRA RODRIGUEZ

Provider Business Mailing Address
First Line	:	5827 W AVENUE K9
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93536-5633
Country	:	US
Telephone Number	:	661-902-9281
Fax Number	:

Provider Business Practice Location Address
First Line	:	5827 W AVENUE K9
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93536-5633
Country	:	US
Telephone Number	:	661-902-9281
Fax Number	:

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

Provider Enumeration Date	:	04/24/2023
Last Update Date	:	04/24/2023

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Directions to “ ALEJANDRA RODRIGUEZ ” Practice Location

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