Basic Information
| Provider Information | |||||||||
| NPI: | 1639534316 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ | ||||||||
| FirstName: | JOSE ALBERTO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DNP, CRNA, APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3310 S CRENSHAW ST APT A | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932778849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035899189 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 115 MALL DR | ||||||||
| Address2: | |||||||||
| City: | HANFORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932305786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5595829000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2015 | ||||||||
| LastUpdateDate: | 02/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN95248512 | CA | N | Nursing Service Providers | Registered Nurse | 163W00000X | 072732 | CT | N | Nursing Service Providers | Registered Nurse | 163WC0200X | 72732 | CT | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine | 207L00000X | NA95001548 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 363L00000X | 6473 | CT | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 367500000X | NA95001548 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | 6473 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.