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NPI Code Detail

MEDICARE: FIDEL JESUS RODRIGUEZ

MEDICARE: FIDEL JESUS 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
11041C0700XClinical Social WorkerASW136349CA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1730998311
Entity Type Code : Individual
Provider Name (Legal Business Name) : FIDEL JESUS RODRIGUEZ
Provider Business Mailing Address
First Line : 3800 WATT AVE STE 100
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-2670
Country : US
Telephone Number : 916-344-0249
Fax Number :
Provider Business Practice Location Address
First Line : 3800 WATT AVE STE 100
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-2670
Country : US
Telephone Number : 916-344-0249
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2025
Last Update Date : 01/15/2026

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Directions to “ FIDEL JESUS RODRIGUEZ ” Practice Location

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