Provider Demographics
NPI:1154710598
Name:RODRIGO, SHEENA (COTA-L)
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:
Last Name:RODRIGO
Suffix:
Gender:F
Credentials:COTA-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 FOOTHILL VIEW PL
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-0940
Mailing Address - Country:US
Mailing Address - Phone:760-703-8259
Mailing Address - Fax:
Practice Address - Street 1:1980 FELICITA RD
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-5922
Practice Address - Country:US
Practice Address - Phone:760-741-6109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OTA2685224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant