Provider Demographics
NPI:1205224813
Name:SAUCEDO, MARIA DEL ROCIO (10469)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DEL ROCIO
Last Name:SAUCEDO
Suffix:
Gender:F
Credentials:10469
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2519 VISTA VERDE DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2058
Mailing Address - Country:US
Mailing Address - Phone:408-428-2659
Mailing Address - Fax:
Practice Address - Street 1:2519 VISTA VERDE DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-2058
Practice Address - Country:US
Practice Address - Phone:408-428-2659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10469225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist