Daniela Ixmucane Rodriguez-Jaquez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

56719 Issued in CA

Practice address

77 Casa St
San Luis Obispo, CA 93405-5803

Phone

(805) 269-1500

Fax

(805) 269-1585

NPI assigned

Jun 12, 2019

Last updated

May 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: daniela.rodriguez-jaquez.1@17363.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Oceano, CA
  • NPI 1336166248
  Medicare reassignment
• Planned Parenthood Mar Monte, Inc

  • Community Health Clinic/Center
  • Stockton, CA
  • NPI 1174579957
  Medicare reassignment
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Paso Robles, CA
  • NPI 1003462102
  NPD
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • San Luis Obispo, CA
  • NPI 1275553257
  NPD
• Community Health Centers of the Central Coast Inc

  • Federally Qualified Health Center (FQHC)
  • Santa Maria, CA
  • NPI 1447277355
  NPD
• Community Health Centers of the Central Coast Inc

  dba Community Health Centers Cambria

  • Federally Qualified Health Center (FQHC)
  • Cambria, CA
  • NPI 1881611705
  NPD
• Planned Parenthood Mar Monte, Inc

  • Community Health Clinic/Center
  • San Jose, CA
  • NPI 1043263189
  NPD
• Planned Parenthood Mar Monte, Inc.

  dba Mar Monte Community Clinic

  • Community Health Clinic/Center
  • San Jose, CA
  • NPI 1598536971
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1275192395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8030",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CASA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055803",
            "telephone_number": "805-269-1500",
            "fax_number": "805-269-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-JAQUEZ",
        "first_name": "DANIELA",
        "middle_name": "IXMUCANE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald E Rocha, M.D.
• Meggan Rodarte, MA, AMFT123424
• Michael Rodgers
• Vance D Rodgers, M.D.
• Lea Rodney
• Ana Rodriguez
• Anaysa Rodriguez
• Daniel Jospeph Rodriguez
• Holli Rodriguez
• Mykel Rodriguez

• Physician Assistant in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.