Provider Demographics
NPI:1962997361
Name:ANG-RODRIGUEZ, MARIA CRISTINA
Entity type:Individual
Prefix:
First Name:MARIA CRISTINA
Middle Name:
Last Name:ANG-RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2239 SWIFT FOX CT
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-0245
Mailing Address - Country:US
Mailing Address - Phone:310-308-9934
Mailing Address - Fax:
Practice Address - Street 1:2239 SWIFT FOX CT
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-0245
Practice Address - Country:US
Practice Address - Phone:310-308-9934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95008763363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily