Provider Demographics
NPI:1164289419
Name:ROJAS, NILLY TAINA
Entity Type:Individual
Prefix:
First Name:NILLY
Middle Name:TAINA
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 1:2526 E NOHL CANYON RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-1705
Mailing Address - Country:US
Mailing Address - Phone:657-245-7126
Mailing Address - Fax:
Practice Address - Street 1:2526 E NOHL CANYON RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-1705
Practice Address - Country:US
Practice Address - Phone:657-245-7126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician