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Search › California › 363A00000X

Nicole Dominique Roderos, PA-C

NPI 1437946381 · on the registry since 2025 · sole proprietor

Practice

Address
1180 N Indian Canyon Dr Ste W201
Palm Springs, CA 92262
Phone
(760) 416-4575
Organisation at this address
Kim Phan Do Pc
Coty Ho Md Inc
Crough Podiatry
Suh Podiatry Llc
Desert Nephrology
Inferred from a shared address, not stated in the registry.
Clinicians at this address
111

Registry record

Primary taxonomy
363A00000X
363A00000X
Also registered as
363AM0700X
363AS0400X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2025-08-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California