Provider Demographics
NPI:1649898743
Name:RODRIGUEZ, AIMEE JOHANNA (APRN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:JOHANNA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3237 GRAND CANAL
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-1707
Mailing Address - Country:US
Mailing Address - Phone:714-425-0730
Mailing Address - Fax:
Practice Address - Street 1:3237 GRAND CANAL
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-1707
Practice Address - Country:US
Practice Address - Phone:714-425-0730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-06
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014811363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily