Provider Demographics
NPI:1851126650
Name:RODRIGUEZ, JANNETTE V
Entity type:Individual
Prefix:
First Name:JANNETTE
Middle Name:V
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANNETTE
Other - Middle Name:V
Other - Last Name:ALONSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2400 GEHRIG ST
Mailing Address - Street 2:#A
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792
Mailing Address - Country:US
Mailing Address - Phone:323-329-0021
Mailing Address - Fax:
Practice Address - Street 1:2400 GEHRIG ST
Practice Address - Street 2:#A
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792
Practice Address - Country:US
Practice Address - Phone:323-329-0021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician