Provider Demographics
NPI:1376744292
Name:ROCA, DEBORA III
Entity Type:Individual
Prefix:MS
First Name:DEBORA
Middle Name:
Last Name:ROCA
Suffix:III
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 1:22455 MAPLE CT
Mailing Address - Street 2:SUITE 402
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-4020
Mailing Address - Country:US
Mailing Address - Phone:510-582-0148
Mailing Address - Fax:510-582-8460
Practice Address - Street 1:22455 MAPLE CT
Practice Address - Street 2:SUITE 402
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4020
Practice Address - Country:US
Practice Address - Phone:510-582-0148
Practice Address - Fax:510-582-8460
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor