Provider Demographics
NPI:1699952879
Name:RODRIGUEZ, ANGELA (CPNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:PALAEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8300 ESTERS BLVD STE 900
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-2233
Mailing Address - Country:US
Mailing Address - Phone:415-424-4266
Mailing Address - Fax:415-520-6633
Practice Address - Street 1:10775 PIONEER TRL STE 215
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-0234
Practice Address - Country:US
Practice Address - Phone:415-424-4266
Practice Address - Fax:415-520-6633
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11018245363LP0200X
CA95020724363LP0200X
COC-APN.0003376-C-NP363LP0200X
NV846570363LP0200X
MDAC005090363LP0200X
VA0024188831363LP0200X
TX1034597363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA100374954Medicaid
NV250016896Medicaid
VA30017724860001Medicaid
FL117508600Medicaid
TX1699952879Medicaid
MD185234500Medicaid