Provider Demographics
NPI:1033435193
Name:ROTTING, MARCO RINI (MSW/ASW)
Entity Type:Individual
Prefix:
First Name:MARCO
Middle Name:RINI
Last Name:ROTTING
Suffix:
Gender:M
Credentials:MSW/ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:867 WALNUT ST
Mailing Address - Street 2:APT. E
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4960
Mailing Address - Country:US
Mailing Address - Phone:707-502-7942
Mailing Address - Fax:
Practice Address - Street 1:867 WALNUT ST
Practice Address - Street 2:APT. E
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4960
Practice Address - Country:US
Practice Address - Phone:707-502-7942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22567174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist