Provider Demographics
NPI:1538909387
Name:RODRIGUEZ, YVETTE MIKA
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:MIKA
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 1:2020 BANCROFT WAY APT 231
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1433
Mailing Address - Country:US
Mailing Address - Phone:510-931-0940
Mailing Address - Fax:
Practice Address - Street 1:2020 BANCROFT WAY APT 231
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1433
Practice Address - Country:US
Practice Address - Phone:510-931-0940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy