Provider Demographics
NPI:1346606316
Name:ROCHA, JESUS
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:
Last Name:ROCHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JESUS
Other - Middle Name:J
Other - Last Name:ROCHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:201 JOHN ST STE G
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3345
Mailing Address - Country:US
Mailing Address - Phone:831-755-8175
Mailing Address - Fax:831-755-8172
Practice Address - Street 1:201 JOHN ST STE G
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3345
Practice Address - Country:US
Practice Address - Phone:831-755-8175
Practice Address - Fax:831-755-8172
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301605171R00000X
CA500058171R00000X
CA100730171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter