Mamie Rodgers

Individual provider Active NPI Homemaker · San Bernardino, CA

NPI 1487203402 · NPPES record last updated Sep 11, 2019

Key facts

NPI
1487203402
Entity type
Individual (NPI type 1)
Primary specialty
Homemaker 376J00000X
Practice address
2557 N Pennsylvania Ave
San Bernardino, CA 92407-6737
Phone
(909) 266-6088
NPI assigned
Sep 11, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Homemaker
Group: 193400000X SINGLE SPECIALTY GROUP
376J00000X Yes

Addresses

Primary practice location

2557 N Pennsylvania Ave
San Bernardino, CA 92407-6737

Mailing address

1380 W 48TH St Unit 33
San Bernardino, CA 92407-5007
Phone (909) 653-3784

Other providers in San Bernardino, CA

All providers in San Bernardino, CA · Homemaker in California

Sources for this page

Verify at the official NPI Registry.