Provider Demographics
NPI:1215534888
Name:AGUERO, ROSA MARIA (PMHNP)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:MARIA
Last Name:AGUERO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9841 ALBURTIS AVE
Mailing Address - Street 2:UNIT 29
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-3264
Mailing Address - Country:US
Mailing Address - Phone:562-607-6895
Mailing Address - Fax:
Practice Address - Street 1:9841 ALBURTIS AVE UNIT 29
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3264
Practice Address - Country:US
Practice Address - Phone:562-607-6895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA787372363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health