Provider Demographics
NPI:1326502923
Name:RODRIGUEZ, DAISY
Entity type:Individual
Prefix:MRS
First Name:DAISY
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:DAISY
Other - Middle Name:
Other - Last Name:GRACIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7824 ROCKHURST WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95828
Mailing Address - Country:US
Mailing Address - Phone:916-738-4946
Mailing Address - Fax:
Practice Address - Street 1:4380 AUBURN BLVD
Practice Address - Street 2:
Practice Address - City:SACREMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841
Practice Address - Country:US
Practice Address - Phone:916-771-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician