Most Relevant Information
Provider Data
| NPI Number: | 1003584293 |
| Provider Name: | JENNIFER RODRIGUEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/01/2021 |
| Last Updated: | 08/10/2022 |
Provider Practice Location
1811 GRAND CANAL BLVD STE 2
STOCKTON
CA
952078107
Practice Location Phone/Fax
| Phone: | 8774182978 |
| Fax: | 8665002186 |
Provider Mailing Location
3132 JEFFERSON ST
SAN DIEGO
CA
921104421
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |