Basic Information
| Provider Information | |||||||||
| NPI: | 1407038466 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ | ||||||||
| FirstName: | ADRIANA | ||||||||
| MiddleName: | CAMPBELL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5296 UNIVERSITY AVE | ||||||||
| Address2: | 5005 TEXAS ST. SUITE 203 SAN DIEGO, CA 92108 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921052269 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192263660 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5296 UNIVERSITY AVE. | ||||||||
| Address2: | 5005 TEXAS ST. SAN DIEGO, CA 92108 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192293660 | ||||||||
| FaxNumber: | 6192652408 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2007 | ||||||||
| LastUpdateDate: | 01/30/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.