Provider Demographics
NPI:1013707926
Name:KUK RODRIGUEZ, DESIREE ARLENE
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:ARLENE
Last Name:KUK 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 1:12021 S. WILMINGTON BLVD
Mailing Address - Street 2:BLDG 18 STE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90059
Mailing Address - Country:US
Mailing Address - Phone:424-454-6081
Mailing Address - Fax:
Practice Address - Street 1:12021 S. WILMINGTON BLVD
Practice Address - Street 2:BLDG 18 STE 301
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059
Practice Address - Country:US
Practice Address - Phone:424-454-6081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator