Provider Demographics
NPI:1043260011
Name:ROJAS, RUTH
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:
Last Name:ROJAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 875
Mailing Address - Street 2:
Mailing Address - City:SABANA SECA
Mailing Address - State:PR
Mailing Address - Zip Code:00952-0875
Mailing Address - Country:US
Mailing Address - Phone:787-376-4042
Mailing Address - Fax:
Practice Address - Street 1:1260 URB LA RIVIERA
Practice Address - Street 2:SE 54
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-1260
Practice Address - Country:US
Practice Address - Phone:787-376-4042
Practice Address - Fax:787-999-5539
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR79321041C0700X
PR4747103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRQ-59601Medicare UPIN
PR0057565Medicare UPIN