Provider Demographics
NPI:1144107871
Name:RODRIGUEZ, SOLEDAD
Entity type:Individual
Prefix:
First Name:SOLEDAD
Middle Name:
Last Name: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 1:310 1/2 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-6036
Mailing Address - Country:US
Mailing Address - Phone:530-978-6504
Mailing Address - Fax:
Practice Address - Street 1:310 1/2 1ST ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-6036
Practice Address - Country:US
Practice Address - Phone:530-978-6504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X
CAE120313146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No372600000XNursing Service Related ProvidersAdult Companion