MEDICARE: KRISTYNNE L. 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	374J00000X	Doula

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457602310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTYNNE L. RODRIGUEZ

Provider Business Mailing Address
First Line	:	5642 DARIEN CT
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92505-2315
Country	:	US
Telephone Number	:	909-767-0951
Fax Number	:

Provider Business Practice Location Address
First Line	:	5642 DARIEN CT
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92505-2315
Country	:	US
Telephone Number	:	909-767-0951
Fax Number	:

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

Provider Enumeration Date	:	10/01/2012
Last Update Date	:	08/01/2025

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